EDVONIQUE EVANS
Summary
Dedicated healthcare professional with experience in customer service, benefits verification, and healthcare enrollment across remote roles. Skilled in managing complex inquiries, ensuring accurate benefit processing, and providing clear support for healthcare and pharmaceutical programs. Proficient in HIPAA compliance, data entry, and using various technology tools to support clients, patients, and employees. Known for strong communication, problem-solving, and emotional intelligence, with a focus on delivering empathetic and efficient service in fast-paced environments.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Home Health Aide
Home Health Agency
08.2023 - 11.2024
- Helped patients maintain personal hygiene through bathing, grooming, and toileting assistance when necessary for dignity preservation.
- Maintained a clean and safe home environment for patients, reducing falls and accidents.
- Assisted clients with daily living activities, enhancing their independence and quality of life.
- Performed light housekeeping duties including laundry linen changes sweeping vacuuming and mopping ensuring a clean and organized living space for patients.
Annual Reverification Specialist
Talent Bridge Agency/ Brystol Myers Squibb
10.2022 - 06.2023
- Company Overview: Bristol Myers Squibb is a global biopharma company firmly focused on its mission to discover, develop and deliver innovative medicines to patients with serious diseases
- Annual Reverification Specialist is a seasonal position that consist of processing applications for the drug Eliquis
- I also processed for Oncology drugs Opdivo, Veroy, Nulojix, Sprycel, and Orencia
- Inbound Phone Queue/General Program Inquires
- Determination for support programs (Copay, PAP, Medicaid, etc.)
- Pharmacy triage and coordination
- Order processing for wholesale orders
- Other follow-up activities (missing info, prior authorization, etc.)
- Intakes and reports adverse events
- Bristol Myers Squibb is a global biopharma company firmly focused on its mission to discover, develop and deliver innovative medicines to patients with serious diseases
Pension Client Representative
Randstad Agency /Alight Solutions
12.2022 - 05.2023
- Pension Client Representative consist of tending to inbound inquiries from current and former employees at the Cleveland Clinic and Cincinnati Children Hospital
- Provides customer service assistance for situations regarding Pension and Health & Welfare plans
- Accepts benefit plan inquiries from plan participants, retirees and beneficiaries
Healthcare Enrollment Specialist
Alight Solutions/Randstad Agency
08.2022 - 12.2022
- Healthcare Enrollment Specialist for manufacture clients Cintas and International Paper
- Answer phone calls from clients, employees and physician offices (enrollment questions, confirming coverage, provider searches, etc.)
- Work closely with Benefit Team to research and correct discrepancies with enrollments and invoices and process retroactive changes
- Support Benefit Team during open enrollment
- Process enrollments, terminations, benefit changes, salary and address changes with applicable carriers and ben admin systems and follow-up to ensure changes are reflected correctly with carriers
- Process COBRA additions and terminations with administrator
- Run dependent age out reports and process enrollment changes accordingly
Benefit Verification Specialist
Caremetx/Randstad Agency
01.2022 - 03.2022
- Collects and reviews all patient insurance information needed to complete the benefit verification process
- Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs
- Verification process could include electronic validation of pharmacy coverage and medical eligibility
- Identifies any restrictions and details on how to expedite patient access
- Could include documenting and initiating prior authorization process, claims appeals, etc
Covid Vaccine Scheduler
Integrated Resources Agency/Maximus
01.2021 - 05.2021
- Schedules, reschedules, and/or cancels COVID vaccine appointments for patients by telephone
- Collects all necessary patient information
- Registers and processes information for the general public for COVID-19 vaccine
- Collects all relevant patient information and schedules follow-up appointments for second COVID-19 vaccine
- Directs patients where to go within vaccination clinic upon entering
Pharmacy Customer Service Associate
TTEC/Optum Rx
09.2020 - 01.2021
- Guide and educate callers on their prescription benefits, use of plan, formulary, premiums and status of orders and claims or inquiries
- Respond to incoming calls from our customers on issues related to benefit eligibility questions and prescription status inquiries
- Identify issues and communicate solutions and steps to customers, pharmacies and physicians with prescription orders and reorders
- Ask appropriate questions and listen actively while documenting required information in computer systems
- Make outbound calls to customers on prescription orders and payment issues
Education
Medical Billing And Coding
Penn Foster Career School
Scranton, PA08-2024
High School Diploma -
Alcovy High School
Covington, GA05-2019
Skills
- Telehealth
- HIPAA Compliance
- Microsoft/Excel/PowerPoint
- Conflict Resolution
- Data Entry
- Effective Communication
- Empathy
- Scheduling Software
- Medical Terminology
- Customer Service
- Time Management
- Adaptability
- Troubleshooting
- Patience
- Emotional Intelligence
Certification
- Medical Billing and Coding Fundamentals
- Certified Nursing Assistant
- Information Technology Support Professional
- Data Analytics Professional
Timeline
Home Health Aide
Home Health Agency
08.2023 - 11.2024
Pension Client Representative
Randstad Agency /Alight Solutions
12.2022 - 05.2023
Annual Reverification Specialist
Talent Bridge Agency/ Brystol Myers Squibb
10.2022 - 06.2023
Healthcare Enrollment Specialist
Alight Solutions/Randstad Agency
08.2022 - 12.2022
Benefit Verification Specialist
Caremetx/Randstad Agency
01.2022 - 03.2022
Covid Vaccine Scheduler
Integrated Resources Agency/Maximus
01.2021 - 05.2021
Pharmacy Customer Service Associate
TTEC/Optum Rx
09.2020 - 01.2021
- Medical Billing and Coding Fundamentals
- Certified Nursing Assistant
- Information Technology Support Professional
- Data Analytics Professional
Medical Billing And Coding
Penn Foster Career School
High School Diploma -
Alcovy High School
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