Summary
Overview
Work History
Education
Skills
Timeline
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Edwina Rivera

Wesley Chapel,FL

Summary

Supportive Eligibility Specialist with extensive application engagement and dedicated service skills. Bilingual professional with skill to maintain accurate records, schedule appointments and handle various administrative responsibilities. Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.

Overview

10
10
years of professional experience

Work History

Eligibility Specialist

Centene Corporation
11.2021 - Current
  • Leveraged advanced technology tools to streamline data entry tasks while minimizing human error rates.
  • Coordinated referral services for eligible families, connecting them with vital support systems and resources.
  • Supported continuous improvement initiatives within the agency through active participation in training sessions and workshops.
  • Optimized workflow processes through proactive identification of inefficiencies and implementation of targeted improvements.
  • Kept current on industry trends and best practices through ongoing professional development activities, ensuring continued excellence in service delivery.
  • Facilitated smooth transitions between program stages by coordinating closely with internal departments and external partners as needed.
  • Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
  • Conducted extensive research on available resources to connect clients with appropriate community services and support networks.
  • Streamlined application process for clients by implementing efficient case management techniques, improving overall service.
  • Maintained detailed records of client interactions, ensuring accuracy and confidentiality of sensitive information.
  • Ensured compliance with local, state, and federal regulations during all phases of the eligibility determination process.
  • Developed strong rapport with clients by effectively communicating complex program requirements and processes.
  • Interviewed applicants and explained scope of different available benefits.
  • Established databases to track, analyze and automate eligibility application processes.
  • Trained staff on current eligibility requirements and policies.
  • Resolved discrepancies with client applications to verify eligibility.
  • Devised and implemented strategies to streamline eligibility verification processes.
  • Assisted clients with accurate eligibility form, application and document completion.
  • Assisted clients with completion of applications and paperwork.
  • Processed and certified documents for accuracy and compliance with government regulations.
  • Engaged wider departments in accurate, timely paperwork completion.
  • Developed extensive fact-checking and research skills by continuously reviewing different programs and options.

Program Coordinator

Centene
01.2014 - 10.2021
  • Optimized resource allocation by using data analysis techniques to determine the most effective way of balancing project priorities and personnel availability, ultimately meeting deadlines with high-quality outcomes.
  • Coordinated cross-functional teams to ensure timely completion of program deliverables, maintaining project schedules and meeting objectives.
  • Enhanced program efficiency by streamlining processes and implementing innovative solutions.
  • Led training sessions for staff and volunteers, fostering a knowledgeable and cohesive team environment.
  • Monitored performance metrics closely to evaluate areas requiring intervention or adjustment, making data-informed decisions that contributed positively towards overall results.
  • Established strategic partnerships with external organizations, expanding program reach and impact.
  • Implemented evaluation tools to measure program effectiveness, utilizing data-driven insights for continuous improvement.
  • Provided exceptional customer service to program participants through prompt response times and attentive assistance with inquiries or concerns.
  • Ensured seamless handover between different stages of projects by creating standard operating procedures that guided staff involved in various aspects of each task.
  • Organized events and workshops to engage participants, enhancing their learning experience within the program framework.
  • Facilitated regular meetings with team members to discuss progress updates, address challenges, and brainstorm solutions for ongoing success.
  • Cultivated a collaborative work culture by encouraging open communication channels among team members which led increased job satisfaction rates amongst employees.
  • Maintained detailed records of program activities and participant data, ensuring compliance with internal policies and external regulations.


Education

Associate of Science -

St. Petersburg College
Clearwater, FL
01.2026

Skills

  • Resource information
  • Proficiency in Microsoft
  • Knowledgeable in Excel, Sharepoint , Word, TruCare, UMV, DCF systems
  • Clinical Documentation and paperwork

Timeline

Eligibility Specialist

Centene Corporation
11.2021 - Current

Program Coordinator

Centene
01.2014 - 10.2021

Associate of Science -

St. Petersburg College

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Edwina Rivera