Summary
Overview
Work History
Education
Skills
Languages
References
Timeline
Generic

Martha Falcon

Pomona

Summary

Experience Eligibility Specialist with 23 years in the medical field, 10 years in a Psychiatric hospital. My experience helps assist employers and staff to help clients/patients to apply for State and county programs, assist and help families to follow through with the process. Competent Eligibility Specialist with background in evaluating, determining, and documenting program eligibility. Strengths include comprehensive knowledge of local, state, and federal program regulations coupled with strong decision-making abilities.

Overview

16
16
years of professional experience

Work History

Eligibility Specialist

Riverside University Health Systems
Riverside
05.2012 - 12.2024
  • Maintained accurate records in electronic health systems for client management.
  • Collaborated with healthcare providers to verify patient eligibility status.
  • Educated clients about available resources and support services offered.
  • Reviewed applications for eligibility and compliance with regulations.
  • Conducted interviews to gather necessary information from applicants.
  • Maintained comprehensive knowledge of program regulations, policies, and procedures.
  • Reviewed applications for eligibility and determined whether applicants met the criteria to receive benefits.
  • Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
  • Maintained positive working relationship with fellow staff and management.

Client Service Representative

CompSpec
Glendale
04.2009 - 05.2009

Assisted patients with county and state programs.

reviewed accounts for denials and follow up with patients and Government agencies.

Work alongside hospital staff, management, and patients.

Education

Medical Assistant - Medical Assistant

Nova Intitute of Health Technology
Ontario, CA
04-1993

GED -

La Habra High School
La Habra
06-1991

Skills

  • Electronic health records
  • HIPAA compliance
  • Documentation and reporting
  • Government relations
  • Application assessment
  • Knowledgeable in [software]
  • Microsoft office
  • Advocacy and counseling
  • Application review
  • Government Programs Understanding
  • Data entry

Languages

Spanish
Professional

References

References available upon request.

Timeline

Eligibility Specialist

Riverside University Health Systems
05.2012 - 12.2024

Client Service Representative

CompSpec
04.2009 - 05.2009

Medical Assistant - Medical Assistant

Nova Intitute of Health Technology

GED -

La Habra High School
Martha Falcon