Vanessa Melendez
Las Cruces,NM
Summary
Proven Medicaid Eligibility Specialist with a track record of enhancing eligibility determinations and customer service at TEKsystems. Expert in Medicaid knowledge and policy interpretation, coupled with exceptional teamwork abilities. Achieved significant process improvements and efficiency gains, demonstrating a keen ability to analyze and resolve complex issues.
Overview
17
17
years of professional experience
Work History
Medicaid Eligibility Specialist
TEKsystems
10.2023 - Current
- Maintained up-to-date knowledge of relevant laws, regulations, and policy changes affecting Medicaid eligibility determinations.
- Improved customer service experience for applicants, providing clear explanations of eligibility requirements and addressing concerns promptly.
- Enhanced Medicaid eligibility determinations by thoroughly analyzing applicants'' financial and personal information.
- Resolved eligibility discrepancies by carefully reviewing regulations and collaborating with relevant parties to reach accurate determinations.
Patient Account Representative
La Clinica De Familia Inc.
02.2017 - 05.2024
- Assisted colleagues during peak periods or absences, showcasing teamwork skills while maintaining personal workload demands efficiently.
- Posted payments and processed refunds.
- Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
- Worked with outside entities to resolve issues with billing, claims, and payments.
Car Dealership Billing Administrative Assistant
Borman Autoplex
01.2007 - 01.2017
- Proactively identified potential areas for cost savings and efficiency improvements, presenting solutions to management that ultimately led to a more streamlined billing process.
- Participated with management to standardize workflows and improve processes.
- Assisted management in analyzing sales trends and identifying opportunities for improvement based on revenue data analysis.
- Collaborated with finance department to expedite loan approvals, improving overall customer experience.
Education
High School Diploma -
Las Cruces High School
Las Cruces, NM05.2006
Skills
- Application processing
- Medicaid knowledge
- Eligibility Determination
- Policy Interpretation
Languages
Spanish
Native or Bilingual
Timeline
Medicaid Eligibility Specialist
TEKsystems
10.2023 - Current
Patient Account Representative
La Clinica De Familia Inc.
02.2017 - 05.2024
Car Dealership Billing Administrative Assistant
Borman Autoplex
01.2007 - 01.2017
High School Diploma -
Las Cruces High School
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