Ervin Simmons
Forney,TX
Summary
Experienced with employee benefits management, focusing on optimizing benefit plans and enhancing employee satisfaction. Utilizes comprehensive knowledge of benefits administration to streamline processes and ensure compliance. Track record of effective team collaboration and adaptability in dynamic environments.
Overview
13
13
years of professional experience
Work History
Benefits Verification
CVS Caremark Specialty
09.2021 - Current
- Prior Authorization Management: Contact doctors’ offices to obtain prior authorizations and use medical terminology for high-cost medications
- Managed approximately 30 incoming calls, emails and faxes per day from customers
- Patient Financial Responsibility: Accurately quote pricing for medications for a patient and appropriately code and enter text notes into the system
- Conducted regular audits of benefits data to maintain accuracy and compliance with regulations.
- Assisted clients with navigating complex insurance policies, ensuring they understood the extent of their coverage and benefits available to them during the claims process.
Payroll/ Benefits Specialist
One Source Virtual
10.2019 - 09.2021
- Ensured accuracy of payroll processing through diligent data entry, verification of hours worked, and prompt resolution of discrepancies.
- Process lump sum payments and interact with agencies to determine amount to be withheld for quarterly and annual bonus payments, severance and all other lump sum payments
- Maintained up-to-date knowledge of federal, state, and local tax laws to ensure accurate payroll deductions.
- Supported annual open enrollment process, providing employees with clear information about benefit options and changes.
- Established effective communication channels between employees and benefits providers, addressing inquiries and concerns promptly.
- Reconciled monthly benefits invoices, identifying discrepancies and working towards a resolution with vendors.
- Managed approximately 30 incoming calls, emails and faxes per day from customers
Senior Advocate
United Healthcare
11.2016 - 10.2019
- Explained available housing, domestic violence, employment, education and substance abuse treatment resources to clients
- Schedule doctor’s visits, vision, dental and provide transportation thru LogistiCare to and from appointments
- Use resources for Food Banks, Shelter, Locate Home Attendants to help around members’ homes
- Resolve member service inquiries related to Medical Benefits, Eligibility and Claims based on Medicare and Medicaid guidelines
- Increased clients'' understanding of their rights and options by conducting informative consultations.
- Conducted pre-screening activities to determine eligibility for supportive services.
Workforce Management/ Payroll Specialist
AT&T
03.2012 - 11.2016
- Improved operational efficiencies and tracking by creating filing systems to maintain confidential employee documents and reports
- Counsel employees regarding benefit programs including plan features, procedures, eligibility and premium information
- Facilitated new hire on-boarding program by scheduling training initiatives, resolving issues and processing paperwork
- Update and maintain Vacation and Sick Time balances for 150 employees using Workforce and Kronos Software
- Assisted employees with inquiries regarding their paychecks, deductions, and other related issues, providing clear and concise communication.
- Uploaded time records into computer system and made adjustments to create accurate database for payroll processing functions.
Education
Associate of Applied Science Degree - Electronic Telecommunications
Eastfield College
Mesquite, TX05.2014
Skills
- Payroll
- HRIS Systems
- EPIC/EMR Systems
- Revenue Cycle
- Employee Benefits Enrollment
- Customer Service
- Call center experience
- Live chat support
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Benefits Verification
CVS Caremark Specialty
09.2021 - Current
Payroll/ Benefits Specialist
One Source Virtual
10.2019 - 09.2021
Senior Advocate
United Healthcare
11.2016 - 10.2019
Workforce Management/ Payroll Specialist
AT&T
03.2012 - 11.2016
Associate of Applied Science Degree - Electronic Telecommunications
Eastfield College
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