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Conduent - Eligibility Specialist Resume Example

Lkley S. Esavhr
XXXX XXXXX XXXX XXXX, Lafayette, In 47909 | (H) XXXXXXXXXX | XXXXXXXXXXXXXXXXXXXX
Professional Summary

Seasoned Eligibility Specialist with more than 10 years of experience in customer service. Many years of employment, with the same company,  exemplify my loyalty, dedication, and work ethic. Efficiently work with the public assisting the residents of Indiana by providing resources to assist the other wise dependent, to achieve self sufficiency. Enjoy working with others and also capable of completing work assignments unaided. Comfortable and experienced in working in fast or slow paced environments. Reliable, efficient, goal orientated, and extremely eager and ready to conquer any future challenges.

Skills
  • Over 10 years of experience in customer service.  
  • Proficient in Microsoft Word, Microsoft Excel, Microsoft PowerPoint, and Windows Programs
  • Excellent communication skills. Able to work well with others 
  • Outstanding time management skills. Able to multi-task efficiently.
  • Exemplary ability to learn quickly 
Experience
Eligibility Specialist/Benefit Recovery 01/2016 to Current
Conduent West Lafayette, In
  • Research cases to determine if the client and/or agency errors has resulted in an over and/or under payment of benefits.
  • Recalculate budgets, using company standardized templates, to determine the amount of benefits the clients should have received.
  • Complete claims to recover benefits issued in error and/or initiate an auxiliary request for benefits to be awarded that were previously under issued to clients.
  • Update cases with policy findings to support the decisions made to recover or award benefits.
  • Research cases and evidence to confirm whether the error that occurred, was due to the agency or the client.
  • Collect evidence to support the theory that fraudulent activity occurred so that legal action can be pursued.
  • Answer telephones and provide information to clients regarding their case status and/or potential claims
  • Manage electronic filing systems by updating current information into computer databases.
  • Operate office equipment, such as fax machines, copiers, and/or phone systems to assist with preparing each case for finalized action to be taken.
  • Schedule and confirm appointments for clients.
  • Conduct searches to find needed information, using such sources as the Internet and information obtained via anonymous callers etc.
  • Review work done by others to check for accuracy to ensure company policy standards are met.
Eligibility Specialist/Nursing Home Department 04/2013 to 12/2015
Conduent Crown Point, In, 46307
  • Review resources and income to determine Medicaid eligibility for nursing home residents in the state of Indiana.
  • Complete budgets to deviate expenses so that nursing home liabilities can be paid timely.
  • Work closely with Business Office Managers to complete the initial application and/or re-determination process for various clients currently living in their nursing home facilities.
  • Research cases to determine if the state of Indiana has paid nursing home expenses for ineligible clients and determine the amount to be paid back to the state, if applicable.
  • Process cases to recover resources that exceed the eligibility guidelines to repay Medicaid for the expenses that were covered for the ineligible clients.
  • Assist and speak to Power of Attorneys, legal guardians, spouses etc. and provide information regarding the eligibility requirements and policy information for the application process.
  • Process documents into the computer database for record keeping to assist the State of Indiana with determining eligibility for clients.
  • Assist clients, authorized representatives etc. with finding nursing home care in their area
  • Process documents in preparation for cases to be authorized by the state of Indiana
Transaction Processor Coach 11/2010 to 04/2013
Conduent Crown Point, In

  • Monitor work completion for new hires and complete evaluation forms in accordance with company policies to update management on individual performance.
  • Maintain scheduling for breaks, lunches, and meetings.
  • Operate electronic mail systems and provide company policy updates accordingly.
  • Coordinate conferences and/or meetings to update employees with system and company changes that affect their work requirements.
  • Compose, type, and distribute meeting notes, routine correspondence, and/or reports, such as presentations and monthly reports.
  • Review work done by new hires to check for accuracy to ensure that company policies are followed, and also recommend revisions.
  • Assist with computer based training sessions to assist newly hired employees with skills and knowledge to perform their job duties thoroughly and accurately.
Eligibility Specialist/General Changes 05/2009 to 11/2010
Conduent Crown Point, In
  • Answer telephones and give information to clients regarding applications, case status, and/or instructions on how to file an appeal.
  • Process changes to on-going cases, collected from clients and/or outside sources, such as employers, landlords etc.
  • Review documentation for accuracy to confirm to clients whether anything else is required for case processing.
  • Process documents in preparation for authorization by the State of Indiana.
  • Provide information to clients regarding how to apply for various benefits, along with the eligibility requirements.
  • Educate clients on various resources available through the State of Indiana.
  • Assist Indiana residents with voter's registration by mailing voter's registration forms and providing information on how to complete and submit them.
  • Complete and explain budget calculations to applicants, clients, and/or authorized representatives etc.
Front Desk Clerk 02/2008 to 05/2009
Hampton Inn Portage, IN
  • Greet, register, and assign rooms to guests of the hotel.
  • Verify customers' credit, and establish how the customer will pay for the accommodation.
  • Contact housekeeping or maintenance staff when guests report problems.
  • Make and confirm reservations.
  • Keep records of room availability and guests' accounts via computer systems.
  • Conduct nightly audits and deliver guest final receipts prior to 4am.
  • Advise housekeeping staff when rooms have been vacated and are ready for cleaning.
  • Answer inquiries pertaining to hotel services, guest registration, and travel directions, or make recommendations regarding shopping, dining, or entertainment.
  • Prepare for basic food service, such as setting up continental breakfast and coffee and tea supplies.
  • Clean and maintain lobby and common areas, such as restocking supplies and watering plants.
Education
High School Diploma: Jun 2002 West Side High School - Gary, IN
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Resume Details

This is a real resume for a Eligibility Specialist in Lafayette, Indiana with experience working for such companies as Conduent, Hampton Inn. This is one of the hundreds of Eligibility Specialist resumes available on our site for free. Use these resumes as templates to get help creating the best Eligibility Specialist resume.

Previous Companies:

  • Conduent
  • Hampton Inn

Previous Job Positions:

  • Eligibility Specialist
  • Front Desk Clerk

Schools:

  • West Side High School

Level of Education:

  • High School Diploma

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