Rukiya Cook
Merrillville
Summary
Experienced professional with a strong background in Medicaid eligibility determination and case management. Demonstrated proficiency in navigating complex regulations and ensuring compliance. Skilled at fostering team collaboration and achieving measurable results. Recognized for reliability and adaptability in fast-paced and dynamic environments. Possesses expertise in data analysis, client communication, and driving process improvement.
Overview
13
13
years of professional experience
Work History
Medicaid Eligibility Specialist
FreedomCare
09.2024 - 04.2025
- 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.
- Developed strong relationships with healthcare providers, coordinating services effectively to best serve eligible clients.
- Improved client understanding and satisfaction with detailed explanations of eligibility requirements.
- Enhanced team knowledge and performance by developing and delivering comprehensive training sessions.
- Communicated with people from various cultures and backgrounds on application process.
Intake Specialist
FreedomCare
11.2023 - 09.2024
- Answered phone calls and provided new clients with required paperwork to initiate service.
- Increased customer satisfaction with timely follow-ups, ensuring all necessary documentation was collected and processed promptly.
- Maintained high levels of accuracy and compliance in data entry, ensuring all information was correctly entered into the required systems.
- Facilitated smooth transitions between different departments by effectively communicating relevant client information at each stage of their journey within the organization.
- Consistently met or exceeded performance metrics, demonstrating a strong commitment to delivering exceptional service within the Intake Specialist role.
- Collaborated with other departments to streamline workflow processes, resulting in increased efficiency and a more cohesive organizational structure.
- Offered compassionate and attentive guidance to patients during crisis situations.
- Facilitated communication between clients and other service providers.
Intake Specialist
Franciscan Health Michigan City (PACE)
06.2022 - 03.2024
- Answered phone calls for PACE referrals and provided new clients with required paperwork to initiate service.
- Described the PACE program, either by telephone, electronically, or in-person to interested persons including candidates for enrollment, caregivers, or others in the community interested in the PACE program.
- Increased customer satisfaction with timely follow-ups, ensuring all necessary documentation was collected and processed promptly.
- Escalated unresolved issues to supervisor and collaborated with other teams to resolve issues.
- Tracked referrals and follow ups.
- Verified Medicare benefits, work with applicant, and work with participants on annual Medicaid redetermination on initial Medicaid application.
- Updated the PACE Logic and EPIC systems, and Completed the Indiana PASRR Level of Care Screening for Long Term Care Services.
Open Enrollment Benefits Specialist
Ascension St. Vincent Indianapolis Hospital
08.2023 - 11.2023
- Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone and email.
- Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
- Administered benefit programs including new hire enrollments, life event changes, eligibility, deductions, and claim adjudication.
- Updated and/or corrected participants benefit data in both internal and carrier information systems.
- Communicated with participants to clarify the policy, eligibility criteria, and other program elements providing customer service to ensure achievement of Service Level Agreement objectives.
- Entered ad-hoc payment requests for tuition reimbursement.
Medicaid Coordinator
O'Drobinak & Nowaczyk
11.2018 - 03.2022
- Managed caseloads for two Elder Law Attorneys to obtain Medicaid assistance for eligible clients.
- Assisted families with complex paperwork, ensuring accuracy and timely submission of required documents.
- Demonstrated exceptional attention to detail when reviewing documentation for eligibility determination purposes, minimizing errors and delays.
- Improved patient care by efficiently coordinating and managing Medicaid applications and eligibility.
- Managed a high caseload effectively, prioritizing tasks and meeting deadlines consistently while maintaining high standards of service quality.
- Provided personalized support to clients throughout the entire application process, resulting in increased satisfaction levels.
- Served as a liaison between clients and government agencies, effectively resolving issues related to enrollment or benefits access.
- Maintained up-to-date knowledge of state and federal regulations, ensuring compliance in all Medicaid coordination efforts.
Nursing Home Eligibility Specialist
Xerox, ACS/Conduent
02.2013 - 11.2018
- Gathered data for all state assistance programs (Medicaid, SNAP, and TANF) either face-to-face or via inbound calls.
- Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
- Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices.
- Ensured all case processing was according to the Indiana Health Coverage Program Policy Manual guidelines.
- Evaluated financial documents to accurately assess income levels, assets, expenses, and other relevant factors impacting client eligibility status.
- Processed and certified documents for accuracy and compliance with government regulations.
- Improved client satisfaction with prompt and precise communication regarding eligibility status and benefits information.
- Facilitated smoother operations by maintaining up-to-date knowledge of changes in regulations and policies affecting eligibility.
- Reduced case backlog by implementing efficient prioritization strategies for case processing.
Eligibility Specialist
CFA Staffing
11.2011 - 02.2013
- Gathered data for all state assistance programs (Medicaid, SNAP, and TANF) either face-to-face or via inbound calls.
- Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
- Resolved discrepancies with client applications to verify eligibility.
- Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices.
- Ensured compliance with local, state, and federal regulations during all phases of the eligibility determination process.
- Evaluated financial documents to accurately assess income levels, assets, expenses, and other relevant factors impacting client eligibility status.
- Processed and certified documents for accuracy and compliance with government regulations.
- Communicated with people from various cultures and backgrounds on application process.
Education
Associate of Applied Science - Accounting
Brown Mackie College
Merrillville, INSkills
- Application processing
- Eligibility determination
- Regulatory analysis
- Medicaid compliance expertise
- Collaborative teamwork
- Commitment to accountability
- Effective phone interaction skills
- Diversity appreciation
- Skilled in software applications
- Effective interpersonal communication
- Customer engagement skills
- Engaged listener
Timeline
Medicaid Eligibility Specialist
FreedomCare
09.2024 - 04.2025
Intake Specialist
FreedomCare
11.2023 - 09.2024
Open Enrollment Benefits Specialist
Ascension St. Vincent Indianapolis Hospital
08.2023 - 11.2023
Intake Specialist
Franciscan Health Michigan City (PACE)
06.2022 - 03.2024
Medicaid Coordinator
O'Drobinak & Nowaczyk
11.2018 - 03.2022
Nursing Home Eligibility Specialist
Xerox, ACS/Conduent
02.2013 - 11.2018
Eligibility Specialist
CFA Staffing
11.2011 - 02.2013
Associate of Applied Science - Accounting
Brown Mackie College
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