Iris Chamagua

• Responsible for three regional offices, which included Jacksonville, Broward and Miami-Dade County
• Enhanced client satisfaction by providing timely and accurate eligibility determination for various assistance programs.
• Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices.
• Ensured compliance with local, state, and federal regulations during all phases of the eligibility determination process.
• Resolved discrepancies with client applications to verify eligibility.
• Maintained detailed records of client interactions, ensuring accuracy and confidentiality of sensitive information.
• Evaluated financial documents to accurately assess income levels, assets, expenses, and other relevant factors impacting client eligibility status.
• Assisted clients with accurate eligibility form, application and document completion.
• Interviewed applicants and explained scope of different available benefits.
• Streamlined application process for clients by implementing efficient case management techniques, improving overall service.
• Communicated with people from various cultures and backgrounds on application process.

Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations for two regional offices.

• Enhanced client satisfaction by providing timely and accurate eligibility determination for various assistance programs.
• Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices.
• Resolved discrepancies with client applications to verify eligibility.
• Ensured compliance with local, state, and federal regulations during all phases of the eligibility determination process.
• Evaluated financial documents to accurately assess income levels, assets, expenses, and other relevant factors impacting client eligibility status.
• Assisted clients with accurate eligibility form, application and document completion.
• Interviewed applicants and explained scope of different available benefits.
• Increased efficiency in the review process by proactively identifying potential issues and developing actionable solutions.
• Kept current on industry trends and best practices through ongoing professional development activities, ensuring continued excellence in service delivery.

• Focus is on a positive outcome by initiating Medicaid applications and annual reviews as it pertain to hospice care and Nursing Home placement
• Gathering the necessary documentation for determination of ICP/ hospice eligibility and redetermination for re-imbursement of services
• Maintain case load of active patients to monitor continuation of eligibility for a program that maintained a census of over 200 patients.
• Keep on-going communication with business office in nursing facilities to provide status of pending applications, Liaison between Nursing Home facilities and Season Hospice finance department and assist with issues relating to service payment
• Collaborate with admissions department to pre-screen non-funded patients awaiting admission to hospice care
• Educate and communicate with patients and families regarding Medicaid process
• Provide explanation of services pertaining to hospice as needed.

• Position entails initiating admission process for terminally ill patients for the SE Region, which covers Georgia, Jacksonville, and South Florida up to the Homestead area
• Verifying eligibility for reimbursement such as commercial insurance, Medicare and Medicaid
• Covering for Admission Director as needed
• Contacting patient’s family members or health care surrogate to provide explanation of services, present and obtain consent forms, scheduling appointments for admission nurses, following up with referring physician for documentation, entering patient’s information into dual database; updating referral source as needed
• Assisting family members and providers with resolving issues pertaining to service delivery
• Maintain an open line of communication with referral sources, Account Liaisons and upper management.

• Responsible for the direct supervision orientation, coaching and counseling of case management associates and Care Coordinator.
• Developed and implemented comprehensive case management plans to address client needs and goals.
• Analyzed trends and data to inform decision-making and program development.

• Responsibilities included providing HIV counseling and education to clients in the various clinics, including STD and Family Planning.

• Promoted to position on September 2001
• Working independently, responsibilities entailed direct and indirect services for individuals affected with HIV
• Assessment, implementation and coordination of services available internally and externally to meet individual’s health care needs.