Brandie McHayle
Riverview,FL
Summary
Dynamic Benefit Specialist Team Lead at Teksystems, adept at enhancing team performance through effective coaching and compliance management. Recognized for exceptional communication skills and a keen eye for detail, I consistently drive process improvements and achieve high-quality outcomes, ensuring accurate insurance verification and fostering a collaborative team environment.
Overview
16
16
years of professional experience
Work History
Benefit Specialist Team Lead
Teksystems (Supporting Amgen's Tezspire Together Program)
09.2023 - Current
- Coached Customer Service Representatives on policies, performance metrics, and service knowledge.
- Reviewed benefits summaries, tracked results, and conducted coaching sessions for performance enhancement.
- Provided management with actionable feedback to improve processes and boost efficiency.
- Facilitated team meetings to communicate updates and deliver essential training.
- Ensured compliance with updated procedures while supporting new specialists post-training.
- Verified patient benefits through outbound calls to Health Plans for accurate information.
- Resolved inquiries in real-time, maintaining customer focus through effective multitasking.
- Navigated multiple systems to access relevant information for efficient task completion.
Network Service Team Lead
Service Provider, Care Centrix
09.2019 - 05.2021
- Documented benefits and eligibility through thorough research and review.
- Interpreted contract benefits per claims processing guidelines.
- Organized and utilized information on benefits, contract coverage, and policy decisions daily.
- Communicated contract benefits accurately to policyholders, agents, and providers professionally.
- Facilitated access to health insurance by educating Medicare individuals.
- Participated in team-building activities to enhance cross-functional collaboration.
- Reviewed and resolved account and billing discrepancies effectively.
- Assessed payment status of accounts and initiated customer outreach.
Tier 2 Customer Service Representative
Health Net
11.2015 - 01.2018
- Cultivated strong business relationships with health plans and payers.
- Ensured timely issue resolution and escalation as necessary.
- Interpreted, verified, and accurately entered data to process orders, confirming eligibility and benefits through payer websites or outbound calls.
- Coordinated authorizations and referrals for providers and health plan partners.
- Negotiated rates with out-of-network providers to facilitate urgent patient services.
- Achieved top percentile for monthly KPI call conversions and handle time metrics.
- Maintained an exceptional quality score averaging 100% across the department.
- Collected clinical and demographic information to initiate referral processes while verifying benefits coverage with health plans.
General Medicare Tier I Representative
Vangent CMS
06.2014 - 10.2015
- Collaborated with management to achieve daily offline work quotas.
- Maintained high production levels consistently.
- Managed inbound calls to address diverse customer needs.
- Ensured courteous and professional interactions with new patients.
- Provided step-by-step instructions to resolve patient issues effectively.
- Coordinated with customer service manager to uphold service standards.
- Handled high call volumes, verifying account information for Medicare and Medicaid services.
- Trained employees on policies and quality improvement protocols.
Customer Service Officer
United States Navy
05.2009 - 01.2014
- Developed efficient filling systems for sailor inventory access, enhancing time management.
- Managed over $500,000 in logistical inventory with precision and accuracy.
- Executed all assigned tasks flawlessly in high-pressure combat environments.
- Initiated team-building activities to boost team morale and cohesion.
- Entered incoming information into database systems promptly and accurately.
- Generated invoices based on established accounts receivable schedules and terms.
- Contacted clients regarding overdue accounts to negotiate payment plans and restructuring options.
- Verified vendor accounts by reconciling monthly statements and transactions for accuracy.
Education
Entrepreneurship & Innovation -
Hillsborough Community College
Tampa, FL12.2022
High School -
Middleton High School
Tampa, FL05.2008
Skills
- Profit and Loss Reporting
- Microsoft Exchange
- Report Creation
- Insurance Verification
- Communication skills
- ICD 9
- Medical Terminology
- Efficient and Detail-Oriented
- Production Monitoring
- Team-Building Exercises
- Accounts Payable and Receivable
- Upbeat and Positive Personality
- Calm and Professional Under Pressure
- ICD 10
- Conflict resolution
- Team leadership
- Compliance management
- Eligibility verification
- Data Entry
Timeline
Benefit Specialist Team Lead
Teksystems (Supporting Amgen's Tezspire Together Program)
09.2023 - Current
Network Service Team Lead
Service Provider, Care Centrix
09.2019 - 05.2021
Tier 2 Customer Service Representative
Health Net
11.2015 - 01.2018
General Medicare Tier I Representative
Vangent CMS
06.2014 - 10.2015
Customer Service Officer
United States Navy
05.2009 - 01.2014
Entrepreneurship & Innovation -
Hillsborough Community College
High School -
Middleton High School
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