Michele Honse
Benefits & Eligibility Specialist
Gilbert,AZ
Summary
Experienced in benefit eligibility determination, ensuring compliance with regulations governing benefit programs. Conducted thorough investigations into potential fraud cases and communicated effectively with clients regarding their application status and policy changes. Maintained comprehensive knowledge of program regulations while processing applications and verifying applicant information to ensure accuracy and eligibility. Demonstrated strong attention to detail and confidentiality practices in managing sensitive client documentation and data entry tasks.
Overview
8
8
years of professional experience
Work History
Benefit Eligibility Specialist
Department of Economic Security
Chandler, Arizona
11.2021 - 06.2025
- Ensured compliance with all applicable laws and regulations governing benefit programs.
- Assessed potential fraud cases by conducting investigations into suspicious activities.
- Communicated regularly with clients regarding their application status or changes in policies or procedures that may affect them.
- Verified applicant's identity and other relevant documents such as birth certificates or Social Security cards.
- Monitored client accounts for any changes that could impact eligibility requirements.
- Analyzed financial information provided by applicants to verify income levels.
- Assisted clients with completing forms required for processing applications.
- Reviewed applications for eligibility and determined whether applicants met the criteria to receive benefits.
- Maintained comprehensive knowledge of program regulations, policies, and procedures.
- Processed client applications in accordance with established guidelines.
- Conducted detailed interviews with applicants to determine their eligibility for assistance programs.
- Attended regular training sessions to stay up-to-date on new rules and regulations.
- Provided guidance on how to apply for benefits and answered questions related to the process.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Reviewed applications to verify client information and resolve discrepancies.
- Contacted client references and employers to determine legitimacy of applicant information.
- Entered client information and files into databases for further review and tracking.
- Conducted interviews with applicants, explaining benefits process, and which programs were available.
- Granted, modified, denied, or terminated assistance based on key information and eligibility determination.
- Answered questions and responded to inquiries to deliver high level of service to patients.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Informed applicants of other agencies providing useful or related assistance.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Maintained positive working relationship with fellow staff and management.
Sales Associate
Dilliards
Mesa, Arizona
08.2019 - 09.2021
- Greeted customers and provided exceptional customer service.
- Conducted inventories on a regular basis to track stock levels.
- Assisted customers with product selection, sizing and styling.
Worker
McDonald's
Gilbert, Arizona
03.2017 - 06.2021
- Collaborated with other departments to resolve issues during manufacturing operations.
- Trained new employees on safe operating procedures for all machines used in the facility.
- Organized work area at end of shift to ensure it is ready for next day's production run.
- Provided customer service by responding to inquiries, resolving complaints, and addressing issues in a timely manner.
- Communicated regularly with supervisors regarding progress of projects and completed tasks.
- Established professional working relationships with staff from various levels.
- Developed positive customer relationships through friendly greeting and excellent service.
Education
Bachelor of Science - Health Administration
University of Phoenix
Phoenix, AZ 08.2001 - 07.2003
Previously Certified And Licensed - Allied Science Pharmacy
North Central State College
Mansfield, OH 09.2018 - 05.2000
Skills
- Great Communication
- Patience
- Customer Service
- Knowledge in Microsoft
- Intermediate in Google 11
- Knowledge in Medicaid and Medicare
- Knowledge of Policies and procedures
- Problem Escalation and diffusing situations
- Relationship building
- Professional phone etiquette
- Oral Communication
- Pharmacy adjudications
- Pharmacy billing and resolutions
- Medical Terminology
- HIPPA Compliance
- Teamwork abilities
- Infection control
- Regulatory compliance
- Fraud investigation
- Eligibility determination
- Application processing
- Policy interpretation
- Database management
- Attention to detail
- Confidentiality practices
Accomplishments
- Multiple 100% case reads
- Multiple 100% recognition from going above and beyond to help clients
- Recognition from supervisors on helping clients and giving resources they need
- Nominated for employee of month
- Exceeds in customer service
Timeline
Benefit Eligibility Specialist
Department of Economic Security
11.2021 - 06.2025
Sales Associate
Dilliards
08.2019 - 09.2021
Previously Certified And Licensed - Allied Science Pharmacy
North Central State College
09.2018 - 05.2000
Worker
McDonald's
03.2017 - 06.2021
Bachelor of Science - Health Administration
University of Phoenix
08.2001 - 07.2003
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