Toni Lemer

• Conducted initial eligibility screenings for Medicaid and Food Stamp applicants.
• Reviewed applications and supporting documents to determine applicant's eligibility for Medicaid benefits.
• Compiled and documented information regarding applicant's income, assets, insurance coverage and other relevant data.
• Verified accuracy of applicant's financial information against third-party sources such as employers, banks or government agencies.
• Processed requests for changes in existing Medicaid cases.
• Assisted individuals with the completion of complex paperwork related to their application process.
• Researched discrepancies between submitted forms and available records to ensure compliance with regulations.
• Maintained up-to-date knowledge of state and federal regulations pertaining to Medicaid eligibility.

I can perform comfortably in a fast-paced, deadline-oriented work environment. Ability to successfully execute many complex tasks, and to work as a team member as well as independently. I have knowledge in Excel, Microsoft Word, and PowerPoint. I have knowledge in requirements and policies for eligibility programs (MEPD Part I & II, TW programs, SNAP, MA, and TANF), as well as the ability to interpret and apply agency, state, and federal rules, regulations, policies, and procedures. I can screen applicants, verify eligibility criteria, determine case dispositions, handle and resolve complex case issues. I am able to identify problems and evaluate alternatives. I can train new workers and respond to client complaints. I have knowledge in interviewing techniques to obtain personal information, make inquiries, and resolve conflicting statements. I have skills in the use of automated data systems and resources (TIERS, TLM, State Portal, TIERS data broker, Standalone data broker, Standalone BVS, WTPY, SOLQ, and MEPD handbook). Knowledge in Health Insurance Portability and Accountability Act (HIPAA) and tax-sensitive information regulations.

• Provide info to customers in a courteous, polite, and professional manner.
• Perform accurately all data entry
• Assist customers in problem resolution
• Receive and respond to telephone calls.
• Answer questions of a general nature and direct incoming calls
• Initiate follow-up calls to customers
• Maintain confidentiality and security of information.
• Mentor/SME for training purposes when immediate supervisor is not available
• Operate multi-line phone system, answer incoming telephone calls, and perform other clerical duties proficiently and professionally.
• Respond to needs, questions, and concerns of internal and external customers.
• Comply with current and updated policy and procedures.
• Perform other duties as may be assigned by management.

I assisted clients with informed and objective responses to complex or escalated concerns regarding social service eligibility requirements, enrollments, and programs. Retrieve, research, and analyze data from multiple databases (TIERS, CHIP database, and State Portal). Manage and update required spreadsheets for proper tracking and reporting of case issues. Extensive knowledge in TIERS, CHIP databases, SNAP, TANF, CMA, and MEPD programs. Filed complaints and appeals for clients.