Results-driven Eligibility Specialist with Deloitte, skilled in Medicaid application processing and compliance monitoring. Proven ability to enhance documentation accuracy and streamline workflows, achieving a 40% reduction in turnaround time. Strong time management and written communication skills ensure efficient case management and eligibility verification for individuals and families.
Overview
6
6
years of professional experience
Work History
Eligibility Specialist
Deloitte
Dallas, TX
08.2024 - 07.2025
Process Medicaid applications, and verify eligibility for individuals and families.
Register applications using the FFM App and GA Referral systems to ensure accurate data capture.
Handle renewals, intakes, deceased case updates, asset verification, and new hire processing.
Communicate with applicants to collect missing documentation, and clarify requirements.
Ensure tasks are completed within deadlines, and provide regular status updates to supervisors.
Maintain compliance with state and federal Medicaid policies and procedures.
Document workflows and suggest process improvements for consistency and efficiency.
Support the Pathways program, assisting applicants with education and employment data for eligibility review.
I worked on a nursing home application and helped the individual to get their MA benefits.
I worked on Q tracks.
Eligibility Specialist
Deloitte(State of New Mexico )
Dallas, TX
04.2024 - 06.2025
Reviewed and processed Medicaid applications using ASPEN (New Mexico’s eligibility system) to determine initial and ongoing eligibility for individuals and families.
Verified applicant information, including income, assets, and other supporting documents, ensuring compliance with state and federal guidelines.
Registered cases and assisted with FFM (Federally Facilitated Marketplace) transfers to coordinate ACA Medicaid eligibility.
Managed daily tasks such as renewals, intakes, changes, deceased updates, and asset verification tasks.
Communicated with applicants to request missing documentation and to explain program requirements clearly.
Entered accurate data into eligibility systems, and maintained case notes for audits and reviews.
Tracked case progress, prioritized tasks, and met strict processing deadlines to ensure timely benefits.
Collaborated with team leads and supervisors to resolve complex eligibility scenarios, and escalate cases as needed.
Maintained strict confidentiality of applicant information, and adhered to HIPAA and state privacy standards.
Provided feedback on process improvements to support efficiency and consistency across the case processing team.
Data Engineer
GSS Infotech Limited
08.2019 - 07.2021
Conducted comprehensive data analysis using Azure SQL Database and Python, devising and executing highly optimized queries for data extraction, analysis, and validation on large data sets.
Developed Spark applications using PySpark and Spark SQL in Azure Databricks for data extraction, transformation, and aggregation from multiple file formats for analyzing and transforming the data.
Extracted, transformed, and loaded data from source systems to Azure Data Storage services using Azure Data Factory, T-SQL, Spark SQL, and U-SQL, Azure Data Lake Analytics. Processed data within Azure Databricks.
Designed, implemented, and maintained scalable and resilient data pipelines.
Using Azure Data Factory, PySpark, and Airflow, I optimized data ingestion and transformation processes across the enterprise, handling terabytes of data, leading to a 40% reduction in turnaround time.
Developed interactive Power BI dashboards to closely monitor the key performance metrics of the data lake and data platform usage. These visualization strategies significantly reduced the platform failures and resource consumption by 30%.
Managed the codebase using Azure DevOps, Bash, Python, and GitHub, with a focus on maintaining high coding standards and secure operations. Streamlined the Continuous Integration.
Continuous Delivery (CI/CD) process by. Integrating security tools like Azure Security Center and Azure Advisor into the. GitHub pull request workflow.
• Maintained meticulous attention to detail, resulting in high-quality work, and thorough quality checks.
Education
Master of Science - Computer And Information Sciences
University of Texas
TX
05-2023
Skills
Medicaid application processing
Data validation
Case management
Compliance monitoring
Documentation accuracy
Policy implementation
Time management
Application review
Case documentation
Microsoft office
Income verification
Data entry
Written communication
History verification
Medicaid policy compliance
Application processing
Eligibility verification
Timeline
Eligibility Specialist
Deloitte
08.2024 - 07.2025
Eligibility Specialist
Deloitte(State of New Mexico )
04.2024 - 06.2025
Data Engineer
GSS Infotech Limited
08.2019 - 07.2021
Master of Science - Computer And Information Sciences