Covey Paige
Jacksonville,FL
Summary
Experienced professional with extensive background in insurance verification, health benefits, enrollment of benefits, appeals, grievances, compliances, policies, administrative support, customer service, conflict resolution, and education. Skilled in account management, technical support, and creating positive learning environments. Proficient in MS Windows, Microsoft Office Suite, and other software programs while possessing experience in managing diverse tasks in fast-paced settings which includes customer call centers and educational settings.
Overview
20
20
years of professional experience
Work History
Guest Teacher
Educational Support System
Jacksonville, USA
10.2023 - Current
- Successfully manages classrooms of up to 30 students in the absence of regular teachers, maintaining a safe and productive learning environment
- Collaborates with teachers to ensure continuity of instruction and student progress, providing detailed feedback on student performance and behavior
- Skilled in providing individualized support to students with special needs, maintaining accurate attendance data, and contributing to a positive and collaborative school culture
- Facilitates discussions to encourage critical thinking, and student engagement
- Demonstrates flexibility and adaptability in responding to unexpected changes in classroom assignments and schedules
Poll Elections Worker
The Baker County Supervisor of Elections
Macclenny, USA
08.2022 - Current
- A multitasker capable of addressing a high volume of voter concerns and questions, with the highest degree of accuracy and professionalism
- Verifies voter eligibility by checking identification and confirming registration information
- Ensures compliance with election laws and regulations throughout the day of voting
- Records voter turnout data throughout the day of voting, and provides updates as needed
- Conducts post-election duties, such as counting ballots and preparing reports for certification by election officials
Census Enumerator
The United States Census Bureau
Jacksonville, USA
09.2019 - 08.2021
- Acted as the final line of defense in obtaining accurate census counts, contributing to a 98% response rate, and ensuring the community received appropriate federal funding and political representation
- Collaborated with supervisors to streamline procedures, resolve issues efficiently, and implement updated instructions, enhancing team productivity by 15%
- Provided essential contact information for verification purposes, which facilitated accurate data collection and improved census data integrity
Senior Clerk
Northeast Florida State Hospital
Macclenny, USA
07.2018 - 05.2019
- Independently supported the Food Service Director, two Food Service Administrators, eight supervisors, and a Dietitian Supervisor, improving administrative efficiency by 20%.
- Performed all office clerical activities, including writing professional correspondence, emails, and letters, tracking bills and financial documents, managing schedules and travel calendars, preparing meeting agendas, transcribing minutes, circulating plans to staff members, and filing employee and confidential documents, which included the hiring and termination files, FMLA and Workmen's Compensation, sick leave, and donation requests.
- Performed general office duties such as typing, scanning, operating office machines, and sorting documentation.
- Streamlined employee scheduling and payroll processing using Kronos, reducing payroll errors by 25%.
- Guided applicants through the job application and interview process, ensuring 100% compliance with HR procedures, and expediting new hire onboarding by 15%
- Facilitated communication between newly hired employees and the Staff Development/Training Department, enhancing the onboarding experience, and reducing training time by 10%
Assistant Site Director/Administrative Assistant
YMCA of Florida's First Coast
Macclenny, USA
05.2017 - 04.2018
- Coordinated all aspects of branch operations, including payroll and human resources, resulting in a 20% increase in operational efficiency
- Organized and facilitated community and local events, increasing community engagement by 40%
- Streamlined the recruitment process, reducing hiring time by 30%, and ensuring high-quality hires through rigorous screening and background checks
Customer Service Specialist
WageWorks
Tallahassee, USA
01.2012 - 01.2014
- Worked in a call center environment providing one-on-one contact by instructing employees and employers on how to effectively enroll and utilize pretax monies for their core benefits, which include the medical/dependent care flexible spending account(s), Health Savings Account, Health Reimbursement Account, and Flexible Spending/Health Savings Account(s) debit card during the peak season of open enrollment and other major events via calendar years, while maintaining confidentiality and Protected Health Information (PHI)
- Maintained a positive, upbeat, and professional demeanor while referring unresolved issues to the appropriate supervisor(s).
- Effectively documented enrollment requests, status changes, complaints, and grievances with a high level of confidentiality and Protected Health Information (PHI) in accordance with HIPAA.
- Acted as a liaison and guide for employees and employers on health, dental, vision, disability, life insurance, and 401(k) benefits, improving benefit utilization by 20%
- Responsible for verifying patient eligibility, coordinating benefits, and determining patient coverage, and responsibility for services.
- Managed inbound and outbound calls with customers, physician offices, patients, and third-party providers regarding the company's products, co-payments, deductibles, insurance coverage issues, and ensuring that all information was documented in several computer systems.
- Verified and completed insurance verification and coverage for all active employees, COBRA participants, and retirees, ensuring 100% accuracy in benefit activation with insurance companies.
- Educated retirees on their benefits, reconciled payments, and resolved escalated issues, reducing benefit-related complaints by 30%.
- Effectively utilized as a Quality Assurance Agent to assist with listening to and critiquing calls, and providing constructive criticism to enhance the job performances of coworkers, and to inform management of any trending occurrences
- Ensured that SLA(s) (service level agreements) and other metrics were either met or exceeded departmental goals each month, to avoid client penalties.
- Extensive experience in providing customer service related to adherence, after-call work (ACW), and maintaining multiple computer systems while meeting standard call-handling metrics.
Appeals/Change in Status Specialist
Fringe Benefits Management Company
Tallahassee, USA
05.2005 - 01.2012
- Responsible for gathering all pertinent and relevant information from the member and/or provider regarding the grievance or appeal, determining the appropriate resolution of the grievance or appeal per standard policies and procedures, notifying the appropriate parties of the resolution, and ensuring that all internal processes are completed to resolve the issue.
- Exhibited strong written, verbal, and communication skills.
- Composed written correspondence to members in accordance with plan policy.
- Conducted a non-biased, accurate, timely, and comprehensive investigation of all the facts related to the grievance/appeal.
- Met all weekly performance standards and goals set by management and the client.
- Maintained an understanding of how to utilize provider system platforms, and obtain necessary documentation for case files.
- Prepared clear, objective, accurate, and comprehensive case histories for presentation and consideration at committee meetings, including the Board of Directors.
- Delivered comprehensive training sessions for top clients, including the State of New York and the Miami-Dade County Public School District, resulting in a 20% improvement in client satisfaction and process efficiency.
- Participated in the periodic review and update of grievance and appeal policies and procedures to reflect appropriate legal and CMS requirements, as well as participated in periodic CMS audit preparations and regulator meetings and interviews.
- Obtained required signatures on legal documents for quarterly and annual reports for the clients for Service Level Agreements (SLAs).
- Knowledge of compliance, regulatory, federal, and state policies pertaining to insurance rules and regulations.
- Ensure professional and HIPAA-compliant documentation practices.
Education
Associate of Arts - Pharmacy Technician
Ultimate Medical Academy
Clearwater, FL12.2025
Associate of Arts - Business
Tallahassee Community College
Tallahassee, FL05.2002
High School Diploma -
Baker County High School
Glen Saint Mary, FL05.1996
Skills
- Insurance Verification
- Quality Assurance
- Insurance/Benefits Enrollment
- Grievances and Compliance
- Professional Written and Verbal Communication
- Call Center and Customer Service
- Conflict Alleviation and Resolution
- Analytical Thinking
- Relationship Building and Team Management
- Public Speaking
- MicroSoft Word
- PowerPoint
- Excel
- Remote Office Availability
- Problem-Solving
- Project Planning
- Training
- Development
- Recruiting
- Community Outreach
Accomplishments
Furnished upon request
Languages
Spanish, Elementary
Custom
Available upon request
Activities
Available upon request
Timeline
Guest Teacher
Educational Support System
10.2023 - Current
Poll Elections Worker
The Baker County Supervisor of Elections
08.2022 - Current
Census Enumerator
The United States Census Bureau
09.2019 - 08.2021
Senior Clerk
Northeast Florida State Hospital
07.2018 - 05.2019
Assistant Site Director/Administrative Assistant
YMCA of Florida's First Coast
05.2017 - 04.2018
Customer Service Specialist
WageWorks
01.2012 - 01.2014
Appeals/Change in Status Specialist
Fringe Benefits Management Company
05.2005 - 01.2012
Associate of Arts - Pharmacy Technician
Ultimate Medical Academy
Associate of Arts - Business
Tallahassee Community College
High School Diploma -
Baker County High School
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