JILL MACULEWICZ
Starke,FL
Summary
Compassionate Eligibility Specialist motivated to positively impact program operations and participant success with diligent support. Well-trained in Specialty Unit Programs, dedication to continuously enhancing strategies and optimizing assistance. Highly organized and hardworking with strong attention to detail.
Overview
21
21
years of professional experience
Work History
Eligibility Specialist II
State of FL DCF
Gainesville, FL
07.2022 - Current
- Processing ICP, Waiver, HCBS cases. Assisting with RAP, RCG, and GH, TC cases. Case reads for the new workers in the ICP unit. Available to answer general questions regarding policy and case issues.
Eligibility Specialist I
State of FL DCF
Gainesville, FL
04.2020 - 07.2022
- Processing applications and recertifications for the cash assistance, food stamp, and medicaid programs. Conducting phone interviews, verifying income and processing cases timely.
Eligibility Representative
Eligibility Screening Services
Starke, FL
04.2016 - 04.2020
- Screen patients in ER and inpatient for any local, state, or federal programs that may assist with medical coverage. Assist patients with filing Medicaid applications on the DCF website. Maintain follow-up protocol to ensure documents are submitted timely to DCF Educate patients on approved Medicaid or Share of Cost. Apply for Medicare Savings Programs for all Medicare beneficiaries. Update Share of Cost information based on internal and external bills that have been received for patients, and submit these bills for bill tracking with DCF to help meet Share of Cost. Serve as a Certified Application Counselor for the Marketplace. Assist consumers with the Marketplace navigation, and help ensure clients understand their chosen healthcare plan. Work in partnership with the facility financial counselors to help establish payment plans for patients.
Patient Advocate
Bolder Outreach Solutions
Starke, FL
12.2014 - 04.2016
- Screen patients in ER and inpatient rooms for Medicaid eligibility. File Medicaid applications for screened patients on DCF Access website. Follow up with patients whose applications are filed to obtain needed documentation to get their application approved. Help patients understand the Medicaid benefits, share of cost guidelines, and how that works with Medicare as primary insurance. Apply for Medicare Savings Programs for all Medicare beneficiaries to help the patients. Review bills on a daily basis to see if share of cost is met, update charges in database. Submit bills to DCF for bill tracking. Obtain additional bills from physician's billing services to help meet share of cost when share of cost is not met with hospital charges.
Program Assistant
University of Florida, College of Medicine
Gainesville, FL
05.2007 - 12.2014
- Planned and coordinated logistics and materials for board meetings, committeemeetings and staff events.Ordered and distributed office supplies while adhering to a fixed office budget. Coordinated domestic and international travel arrangements, including booking airfare, hotel and transportation. Managed office supplies, vendors, organization and upkeep. Coordinated board and committee meetings, including schedules and information preparation and distribution. Prepare Expense Reports, Travel Authorizations in the PeopleSoft system for twenty staff members. Approve time in the PeopleSoft system for exempt and non-exempt employees. Data entry of services into the Healthy Families Florida tracking system. Run reports as requested. Served as the contact person for maintenance requests, contacting the landlord when problems arise, following up when necessary. Oversaw heavy load of administrative tasks while verifying accuracy and prompt completion of paperwork.
Human Service Program Records Analyst
Agency for Healthcare Administration
Alachua , FL
04.2003 - 07.2007
- Answered up to 100 calls per day from Medicaid beneficiaries with questions regarding Medipass managed care program. Processed primary care physician changes Assisted with direct client reimbursement. Helped beneficiaries obtain specialist information and answer questions about limits of Medicaid coverage. Process managed care exemptions and track through excel. Assist supervisor with credentialing of Medipass providers by obtaining required documentation, and tracking in Access database.
Education
High School Diploma -
Gainesville High School
Gainesville, FL06-1989
Associate of Arts - Business Administration
Santa Fe College
Gainesville, FLSkills
- Telephone Etiquette
- Applicant support and service
- Proficiency in Microsoft Office
- Documentation and paperwork
- Application assessment
- Effective communication skills
- Public assistance programs
- Social Services
- Disability Awareness
- Income verification
- Government relations
- Medicaid knowledge
- Verbal Communication
- Application Review
Timeline
Eligibility Specialist II
State of FL DCF
07.2022 - Current
Eligibility Specialist I
State of FL DCF
04.2020 - 07.2022
Eligibility Representative
Eligibility Screening Services
04.2016 - 04.2020
Patient Advocate
Bolder Outreach Solutions
12.2014 - 04.2016
Program Assistant
University of Florida, College of Medicine
05.2007 - 12.2014
Human Service Program Records Analyst
Agency for Healthcare Administration
04.2003 - 07.2007
High School Diploma -
Gainesville High School
Associate of Arts - Business Administration
Santa Fe College