COREY ROSINSKI
Benefits & Eligibility Rep
Malden,MA
Summary
A highly motivated and experienced Health Insurance Specialist with an in-depth knowledge of the insurance industry. Possessing excellent customer service, communication, training, and problem-solving skills. Personable and detail-focused individual with strong ability to navigate complex eligibility criteria and provide excellent customer service. Familiar with key aspects of eligibility determination, including data entry and regulatory compliance. Capable of ensuring accurate and timely processing to enhance organizational efficiency and client satisfaction.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Benefits and Eligibility Rep
Commonwealth of Massachusetts
05.2023 - Current
- Assist individuals and families, individuals with disabilities, and others to determine initial and continued eligibility for MassHealth benefits
- Process applications and administer case management via phone or in-person
- Assist members to navigate and complete online applications
- Evaluate and review submitted documents to ensure accuracy and completeness of information
- Validate customer demographic, financial, and background data through contacting applicants and collateral sources
- Provide requested services and appropriate referrals for customers to external programs for which they may qualify
- Validate customer demographic, financial, and background data
- Represent the agency at appeal hearings and explain eligibility determinations
- Reconcile MassHealth case information with information from other agencies and sources
- Respond to customer inquiries and provide information regarding eligibility requirements
- Provide quality customer service by responding to inquiries in a professional, efficient, and courteous manner.
Talent Acquisition Coordinator
Mass General Brigham, PeopleSoft
03.2022 - 05.2023
- Provided a high level of customer service and maintained quality throughout the pre-employment onboarding process
- Ensured the completion and accuracy of all pre-employment processes and forms according to policy and guidelines, including the initiation of background checks and drug tests, and licensure verification
- Conducted I-9 E-Verify checks using the HireRight website to verify the work eligibility of newly hired employees
- Maintained regular communication with hiring managers, HR Business Partners, and Talent Acquisition Partners
- Created and maintained, records for new hires
- Coordinated with HRIS, Occupational Health, and other departments as necessary for various onboarding needs
- Utilized reports in Taleo to plan for upcoming new hires
Floor Support
Boston Medical Center Healthnet Plan
11.2017 - 03.2022
- Answered incoming calls from providers that had inquiries about eligibility and benefits, claims/appeals, or authorizations on members’ accounts
- Resolved customer inquiries and problems through effective interaction with both internal and external staff‚ particularly in the areas of marketing‚ enrollment‚ provider relations‚ customer care center leadership
- Exceeded department’s quality and productivity goals
- Trained in provider appeals and assisted with inventory projects
- Active assist line/floor support rep who assisted other employees with member/provider line inquiries
- Accurately assisted providers with member plan benefit info and checking medical codes to make sure they are valid and billable
- Assisted with 5 new hire classes full-time remotely for a period of five weeks each
- Helped develop training materials and assisted with assessment grading and creation
- Trained co-workers on prior auth dept in a customer care role
- Adjudicated claims and assisted the claims department with inventory
Uber Service Provider/Driver
Uber Rideshare
09.2015 - 08.2017
- Provided safe and reliable transportation to Boston area riders
- Provided over 3,000 rides and maintained a 5/5 customer rating
Direct Care Counselor
Communities For People, Inc
, IL
08.2014 - 11.2015
- Helped clients develop and follow treatment plans/set and achieve other personal goals
- Handled cooking and cleaning; encouraged youth to participate in order to assist with independent living skills
- Administered daily meds in accordance with current MAP policies
- Served as an advisor to specific youth to handle all school/doctor appointments, court issues, and treatment meetings (transported clients as well)
- Educated clients on health and hygiene issues
- Documented activities and interactions of each client daily
- Documented weekly progress on advocacy reports
- Communicated with clinicians/social workers/families on each client’s progress
- Maintained and ordered needed supplies for the facility
- Helped with overnight shifts as needed
- Conducted regular safety checks within the residential environment to minimize risk factors associated with potential accidents or incidents involving clients.
- Served as a liaison between clients, their families, and the treatment team, fostering strong communication channels and promoting collaborative care efforts.
- Coordinated discharge planning efforts to ensure seamless transitions back into the community following program completion.
- Developed strong rapport with clients, fostering trust and promoting effective communication for better understanding of their needs.
Blue Cross Blue Shield
05.2013 - 09.2013
- Supported doctors’ offices in obtaining prior authorizations
- Rendered exceptional customer service and met volume deadlines and timetables
- Ensured the appropriate use of selected prescription drugs
- Prevented the improper prescribing or use of certain drugs
- Coordinated and communicated with doctors/pharmacists to prescribe an alternate drug beneficial for the patient
- Consulted with presiding pharmacists to obtain clearance for the necessity of treatment
- Look through insurance plans in a detailed manner and process required referrals
- Keep medical staff in the loop about any delays or problems in obtaining authorizations
- Apply billing and coding principles in sync with government policies and standards
- Verify patients’ benefits and ensure that proper prior authorization and re-authorization is obtained for additional treatment
Desktop Support Intern
Dell Services/Tufts Medical Center
07.2012 - 01.2013
- Maintained, analyzed, performed troubleshooting, and repaired computers/laptops, hardware, software, and peripherals
- Created user accounts, including user rights, security, and groups creation
- Installed or advised installation of upgrades to prevent malfunctioning and instructed employees how to prolong functionality by proper use
- Responsible for the imaging, configuring, and deployment of department-specific laptops and desktops
- Experience troubleshooting Windows XP and Windows 7 operating systems
- Utilized Remedy ticketing system for user issues
Education
Psychology
Liberty University
Sept. 2015
B.S - Management
Cambridge College
Jan. 2013
Business Office Technologies Certificate - undefined
Grafton Job Corps
June 2004
Certification
Cisco I.T Essentials Certification
MAP Certification
CPR/First Aid
CPI Training
Skills
Client relationship building
Healthcare industry
Policy interpretation
Confidentiality
Work Preference
Work Type
Full TimeWork Location
On-SiteRemoteHybridImportant To Me
Career advancementWork-life balanceCompany CultureTimeline
Benefits and Eligibility Rep
Commonwealth of Massachusetts
05.2023 - Current
Talent Acquisition Coordinator
Mass General Brigham, PeopleSoft
03.2022 - 05.2023
Floor Support
Boston Medical Center Healthnet Plan
11.2017 - 03.2022
Uber Service Provider/Driver
Uber Rideshare
09.2015 - 08.2017
Direct Care Counselor
Communities For People, Inc
08.2014 - 11.2015
Blue Cross Blue Shield
05.2013 - 09.2013
Desktop Support Intern
Dell Services/Tufts Medical Center
07.2012 - 01.2013
Psychology
Liberty University
B.S - Management
Cambridge College
Business Office Technologies Certificate - undefined
Grafton Job Corps
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