Juanita Ortiz
Odessa,TX
Summary
Dynamic Medicaid Eligibility Specialist with proven expertise in application processing and client engagement at the Health and Human Services Commission. Recognized for enhancing client satisfaction through effective communication and meticulous attention to detail, consistently achieving high performance metrics in eligibility assessments and case management. Committed to fostering self-sufficiency and resource access for diverse populations.
Experienced eligibility professional with strong background in assessing and determining client eligibility for various programs. Skilled in data analysis, client interviews, and documentation management. Strong focus on team collaboration and achieving results, adaptable with changing needs. Reliable and efficient, consistently meeting deadlines and maintaining high standards in service delivery.
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.
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Hardworking and passionate job seeker with strong organizational skills eager to secure an entry-level position in Social Work. Ready to help team achieve company goals.
Overview
23
23
years of professional experience
Work History
Out-stationed Eligibility Worker II
Health and Human Services Commission
04.2025 - Current
- Conducted comprehensive income calculations for clients seeking public assistance, ensuring appropriate benefit levels were assigned based on financial need.
- Interviewed applicants and explained scope of different available benefits.
- Assisted clients in understanding complex program requirements through clear explanations and provision of informational resources.
- Supported colleagues during periods of high workload volume by prioritizing tasks effectively and assisting with overflow case management duties when needed.
- Maintained confidentiality at all times while handling sensitive client data related to personal finances, health concerns, and family situations.
- Demonstrated attention to detail when reviewing applications for accuracy, completeness, and adherence to guidelines.
- Scheduled appointments with applicants to gather information and explain benefits processes.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Enhanced client satisfaction by providing efficient and accurate eligibility assessments for various social service programs.
- Monitored caseloads closely to ensure timely action was taken on all pending applications according to agency guidelines.
- Maximized departmental efficiency by maintaining a well-organized workspace and filing system, ensuring easy retrieval of necessary documents at all times.
- Established rapport with clients through empathetic listening, clear communication, and professional demeanor during interviews.
- Liaised with other social service providers as necessary in order to coordinate support efforts for mutual clients in need of multiple forms of assistance simultaneously.
- Enhanced client self-sufficiency through the provision of referrals to applicable community resources and support services.
- Prevented unauthorized access to sensitive client files by adhering strictly to established security protocols regarding document storage and disposal.
- Proactively identified potential fraud cases through diligent review of application materials and referral to appropriate channels for further investigation.
- Exemplified professionalism and commitment to public service excellence by consistently meeting or surpassing established performance metrics related to application processing speed, accuracy, and client satisfaction ratings.
- Streamlined application processing times by maintaining thorough knowledge of program rules, regulations, and requirements.
- Managed processing of financial assistance and food stamp benefits applications.
- Expedited case reviews by promptly responding to requests for additional information or documentation from supervisors or other agencies.
- Processed and certified documents for accuracy and compliance with government regulations.
- Communicated with people from various cultures and backgrounds on application process.
- Assisted clients with accurate eligibility form, application and document completion.
- Reviewed applications for different aid programs and determined which qualification criteria for individuals.
- Assisted many clients with completion of applications and paperwork.
- Reduced errors in case management by consistently updating client information in the database system.
- Resolved discrepancies with client applications to verify eligibility.
Medicaid Eligibility Worker II
Health and Human Services Commission
06.2023 - 04.2025
- Conducted comprehensive income calculations for clients seeking public assistance, ensuring appropriate benefit levels were assigned based on financial need.
- Interviewed applicants and explained scope of different available benefits.
- Assisted clients in understanding complex program requirements through clear explanations and provision of informational resources.
- Supported colleagues during periods of high workload volume by prioritizing tasks effectively and assisting with overflow case management duties when needed.
- Scheduled appointments with applicants to gather information and explain benefits processes.
- Enhanced client satisfaction by providing efficient and accurate eligibility assessments for various social service programs.
- Maintained confidentiality at all times while handling sensitive client data related to personal finances, health concerns, and family situations.
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
- Monitored caseloads closely to ensure timely action was taken on all pending applications according to agency guidelines.
- Maximized departmental efficiency by maintaining a well-organized workspace and filing system, ensuring easy retrieval of necessary documents at all times.
- Established rapport with clients through empathetic listening, clear communication, and professional demeanor during interviews.
- Liaised with other social service providers as necessary in order to coordinate support efforts for mutual clients in need of multiple forms of assistance simultaneously.
- Enhanced client self-sufficiency through the provision of referrals to applicable community resources and support services.
- Prevented unauthorized access to sensitive client files by adhering strictly to established security protocols regarding document storage and disposal.
- Reduced errors in case management by consistently updating client information in the database system.
- Collaborated with team members to ensure consistent delivery of services and optimal client outcomes.
- Proactively identified potential fraud cases through diligent review of application materials and referral to appropriate channels for further investigation.
- Exemplified professionalism and commitment to public service excellence by consistently meeting or surpassing established performance metrics related to application processing speed, accuracy, and client satisfaction ratings.
- Streamlined application processing times by maintaining thorough knowledge of program rules, regulations, and requirements.
- Managed processing of financial assistance and food stamp benefits applications.
- Expedited case reviews by promptly responding to requests for additional information or documentation from supervisors or other agencies.
- Increased efficiency within the department by creating detailed procedural manuals that outlined best practices for daily tasks such as interviewing clients, processing applications, and conducting follow-ups on cases under review.
- Contributed to ongoing process improvement initiatives by providing valuable feedback on procedures and practices during team meetings and training sessions.
- Processed and certified documents for accuracy and compliance with government regulations.
- Communicated with people from various cultures and backgrounds on application process.
- Resolved discrepancies with client applications to verify eligibility.
- Assisted clients with accurate eligibility form, application and document completion.
- Engaged wider departments in accurate, timely paperwork completion.
- Established databases to track, analyze and automate eligibility application processes.
- Reviewed applications for different aid programs and determined which qualification criteria for individuals.
- Trained staff on current eligibility requirements and policies.
- Built relationships with diverse stakeholders to achieve successful program implementation.
- Assisted clients with completion of applications and paperwork.
- Sorted out jobs relevant to interests of candidates to forward information to candidates.
- Communicated with legal representatives for clients who resided in nursing facilities or state hospitals for eligibility.
- Kept files on all clients on all applications and completed annual reviews.
- Displayed professional attitude, actions and work attire and demonstrated appropriate respect for cultural diversity among co-workers and a work related contacts.
Customer Service Representative
Social Security Adminstration
11.2022 - 06.2023
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Negotiated solutions with dissatisfied customers, turning potential negative reviews into positive testimonials.
- Participated in training programs to enhance product knowledge and customer service skills.
- Maintained detailed records of customer interactions, contributing to comprehensive database for future reference.
- Addressed customer inquiries to ensure satisfaction and foster positive service experience.
- Improved resolution time with effective problem-solving for customer complaints.
- Resolved escalated customer issues, restoring confidence in company's commitment to service excellence.
- Exhibited high energy and professionalism when dealing with clients and staff.
- Investigated and resolved customer inquiries and complaints quickly.
- Delivered prompt service to prioritize customer needs.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Sought ways to improve processes and services provided.
- Maintained strict confidentiality of applicant information, adhering to all applicable privacy laws and regulations.
Medicaid Eligibility Specialist III
Health and Human Services Commission
03.2003 - 10.2022
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Negotiated solutions with dissatisfied customers, turning potential negative reviews into positive testimonials.
- Participated in training programs to enhance product knowledge and customer service skills.
- Maintained detailed records of customer interactions, contributing to comprehensive database for future reference.
- Addressed customer inquiries to ensure satisfaction and foster positive service experience.
- Improved resolution time with effective problem-solving for customer complaints.
- Resolved escalated customer issues, restoring confidence in company's commitment to service excellence.
- Exhibited high energy and professionalism when dealing with clients and staff.
- Investigated and resolved customer inquiries and complaints quickly.
- Delivered prompt service to prioritize customer needs.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Sought ways to improve processes and services provided.
- Maintained strict confidentiality of applicant information, adhering to all applicable privacy laws and regulations.
Education
High School Diploma -
Iraan High School
Iraan, Texas05.1980
Bachelor of Science - Child And Family Studies-Sociology/Spanish
University of Texas of The Permian Basin
Odessa05-2007
Associate of Science - Elementary Education
Howard College
Big Spring, TX05-1999
No Degree - Office Machines
American Commercial College
San Angelo, TX11-1981
Skills
Written and verbal communication
- Application processing
- Telephone etiquette
- Cross-cultural sensitivity
- Confidentiality
- Effective customer communication
- Social program eligibility
- Benefits programs
- Documentation and paperwork
- Data entry
- Knowledgeable and Proficient in Microsoft Word, Excel, 10-key, Outlook, Teams, Skype, Internet, State Portal, Data Broker, SASO, YourTexasBenefitscom, TIERS programs for Health and Human Services Commission
- Policy interpretation
- Resource information
- Teamwork and collaboration
- Attention to detail
- Time management
- Multitasking
- Reliability
- Excellent communication
- Organizational skills
- Active listening
Languages
Spanish
Native or Bilingual
Timeline
Out-stationed Eligibility Worker II
Health and Human Services Commission
04.2025 - Current
Medicaid Eligibility Worker II
Health and Human Services Commission
06.2023 - 04.2025
Customer Service Representative
Social Security Adminstration
11.2022 - 06.2023
Medicaid Eligibility Specialist III
Health and Human Services Commission
03.2003 - 10.2022
High School Diploma -
Iraan High School
Bachelor of Science - Child And Family Studies-Sociology/Spanish
University of Texas of The Permian Basin
Associate of Science - Elementary Education
Howard College
No Degree - Office Machines
American Commercial College
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