Summary
Overview
Work History
Education
Skills
Timeline
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Regine Keenan

Tampa,FL

Summary

Results-driven Medicare Eligibility Specialist with a proven track record, adept in CMS compliance and enrollment processing. Demonstrated ability to reduce eligibility determination errors through meticulous attention to detail and strong analytical skills. Proficient in Word and Excel, with excellent communication skills to resolve member inquiries effectively.

Overview

12
12
years of professional experience

Work History

Medicare Eligibility Specialist

Nirvana Health
07.2024 - 07.2025
  • Process enrollment applications, disenrollments, cancellations, and eligibility changes promptly and accurately.
  • Ensures appropriate letters are sent to members within CMS timeframes.
  • Review and process daily Transaction Reply Reports from CMS
  • Handle complaints regarding eligibility and enrollment.
  • Assist with monthly projects and audits.
  • Reduced errors in eligibility determinations by maintaining thorough knowledge of guidelines and regulations.


Senior Data Entry Clerk

United Healthcare
06.2022 - 07.2024
  • Process all mail for members who have been court-ordered to provide health insurance for their dependents.
  • Conducts system research to support the appropriate mailing of documents/correspondence.
  • Receives, opens, and sorts mail daily for distribution.
  • Keep a daily record of incoming and outgoing mail.

Eligibility Representative II

Centene
06.2018 - 05.2022
  • Maintain accurate eligibility records for assigned lines of business. Enters system eligibility data daily, including new enrollees, changes, and cancellations.
  • Interact with staff in other departments to clarify and resolve eligibility presented by the member.
  • Maintain quality and production standards as outlined by the department.


EDI Enrollment Specialist

Health Plan Services
01.2014 - 05.2018
  • Process electronic enrollment files (834s) for multiple health plans, ensuring timely and accurate member updates.
  • Applied appropriate disposition and/or action to resolve discrepancies.
  • Ability to read, understand, and evaluate complex 834 transactions and correlate data to identify where processing issue/gap exist.

Education

High School Diploma -

Spoto
Tampa, FL
01-2012

Skills

  • CMS compliance and guidelines
  • Medicare/Medicaid Eligibility
  • Enrollment &application processing
  • Word, Excel, SharePoint, MARx
  • EDI 834 transactions

Timeline

Medicare Eligibility Specialist

Nirvana Health
07.2024 - 07.2025

Senior Data Entry Clerk

United Healthcare
06.2022 - 07.2024

Eligibility Representative II

Centene
06.2018 - 05.2022

EDI Enrollment Specialist

Health Plan Services
01.2014 - 05.2018

High School Diploma -

Spoto

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Regine Keenan