medicaid eligibility specialist resume example with 3+ years of experience

(555) 432-1000,
, , 100 Montgomery St. 10th Floor
Professional Summary

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

  • Resource information
  • Appointment Scheduling
  • Effective communication skills
  • Program knowledge
  • Applicant engagement
  • Application Review
Southeastern College Charlotte, Expected in 07/2021 Certified Electronic Medical Billing And Coding : Electronic Medical Billing And Coding Specialist - GPA :
West Stanly High School Oakboro, NC Expected in 06/2012 High School Diploma : - GPA :
Work History
Cbiz, Inc. - Medicaid Eligibility Specialist
Clearwater, FL, 08/2021 - Current
  • Communicated with people from various cultures and backgrounds on application process.
  • Documented all communication with applicants and inputted information into system using Centene.
  • Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
  • Scheduled appointments with applicants to gather information and explain benefits processes.
  • Reviewed applications for different aid programs and determined which qualification criteria for individuals.
  • Inputted all gathered information and researched data on applicants into computer system using EDS .
  • Assessed information gleaned from interviews, educational, and medical records, consultation with other professionals and diagnostic evaluations to identify clients' abilities, needs and eligibility for services.
  • Developed extensive fact-checking and research skills as result of continuously reviewing different programs and options.
North American Construction Group - Medical Billing Customer Service Specialist
Fargo, ND, 08/2019 - 08/2020
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Posted and adjusted payments from insurance companies.
  • Located errors and promptly refiled rejected claims.
  • Precisely evaluated and verified benefits and eligibility.
  • Identified and resolved patient billing and payment issues.
  • Trained new employees on multiple medical billing programs and data entry software.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
  • Determined prior authorizations for medication and outpatient procedures.
  • Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
Teletech - United Health Care Medicare and Retirement
City, STATE, 03/2016 - 03/2018
  • Reviewed and verified addresses, phone numbers, names, ages, and values.
  • Responded to inquiries from callers seeking information.
  • Checked documentation for accuracy and validity on updated systems.
  • Processed and recorded new policies and claims.
  • Calculated adjustments, premiums, and refunds.
  • Collected premiums and issued accurate receipts.
  • Generated, posted and attached information to claim files.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Maintained confidentiality of patient finances, records and health statuses.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Communicated effectively with staff members of operations, finance and clinical departments.
Meineke - Mechanic
City, STATE, 01/2016 - 02/2018
  • Replaced damaged, missing or defective parts with new and refurbished components.
  • Performed diagnostic and troubleshooting procedures to find and identify root causes of mechanical issues.
  • Completed full vehicle inspections to check for leaks, damage or other issues of concern.
  • Inspected and tested vehicles and completed preventive maintenance such as engine tune-ups, oil changes, tire rotations, wheel balancing and filter replacement.
  • Kept equipment in good working order by following operating instructions, troubleshooting breakdowns and maintaining supplies.
  • Inspected and tested equipment to locate worn and damaged parts.
  • Serviced vehicles according to OEM recommended maintenance schedules for oil changes, engine tune-ups and fluid changes.
  • Analyzed and located malfunctions in brakes, motors, switches and control systems.
  • Ordered repair parts quickly to prevent delays in projects and repair work.
  • Inspected vehicles and evaluated condition of systems, equipment, lights and accessories.
  • Disassembled defective parts to make proper repairs.
  • Consulted manuals, technical documentation and repair tree charts for further information prior to conducting fixes.
  • Maintained accurate records of time and materials required to perform repairs and service.
  • Followed established safety procedures and techniques when working under lifted vehicles.
  • Utilized diagnostic equipment to evaluate mechanical problems in vehicles.
  • Maintained functionality and reliability of engines, machines and systems through regular diagnostic checks.
  • Tested newly installed equipment to determine proper functionality and compliance with regulations.
  • Examined new and replacement parts to uncover defects.
  • Corrected unsafe conditions in work areas and immediately reported correctable conditions to supervisor.
  • Demonstrated process of preventive maintenance and visual inspections to junior mechanics.
  • Performed basic electric repairs such as resetting circuit breakers and fitting lighting fixtures.
  • Managed inventory through computerized inventory control system.
  • Diagnosed electrical malfunctions using oscilloscope.

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

Your data is safe with us

Any information uploaded, such as a resume, or input by the user is owned solely by the user, not LiveCareer. For further information, please visit our Terms of Use.

Resume Overview

School Attended

  • Southeastern College
  • West Stanly High School

Job Titles Held:

  • Medicaid Eligibility Specialist
  • Medical Billing Customer Service Specialist
  • United Health Care Medicare and Retirement
  • Mechanic


  • Certified Electronic Medical Billing And Coding
  • High School Diploma

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

*As seen in:As seen in: