Joel Thomas
Fairfield,CA
Summary
Benefits Verification Specialist with 5+ years of experience processing high-volume insurance verifications, resolving complex eligibility issues, and improving claims workflows in remote healthcare environments. Recognized for exceeding productivity goals, training peers, and delivering exceptional customer service while maintaining strict accuracy standards.
Overview
8
8
years of professional experience
Work History
Benefits Verification Specialist
CVS Specialty Pharmacy
Redlands, CA
09.2021 - 03.2026
- Processed 50–80 benefit verifications daily while exceeding productivity requirements and maintaining high accuracy and turnaround standards
- Utilized RxConnect, CoverMyMeds, Availity, and Microsoft 365 to verify benefits, resolve insurance eligibility issues, and coordinate claim process.
- Managed approximately 20 inbound and outbound calls daily to resolve claim issues and deliver timely customer support.
- Resolved hundreds of inquiries weekly through effective client communication and collaboration with peers to review complex insurance eligibility and claims, minimizing processing delays through accurate verification and issue resolution.
- Enhanced claim processing efficiency by following established protocols and identifying new approaches for optimized workflow.
- Improved accuracy in claim approvals by conducting training sessions that taught effective strategies to peers.
Freelance Audio Engineer (Part-Time)
Self-Employed
Remote
03.2020 - 09.2021
- Completed various freelance contracts remotely in digital audio, including audio editing, processing, clarifying surveillance audio for law enforcement, and producing podcast episodes to meet client needs.
- Recorded and mixed audio for various projects using industry-standard software.
- Collaborated with artists to achieve desired sound quality and artistic vision.
- Operated studio equipment to ensure optimal recording conditions and performance.
- Pursued freelance digital audio projects to enhance technical skills and gain diverse industry experience.
Administrative & Media Production Support
Must Amplify
Remote
12.2018 - 02.2020
- Assisted in production and post-production of television, radio, and audio streaming projects, collaborating with performers and producers to meet creative goals.
- Collaborated with teams to successfully deliver multimedia projects.
- Managed digital and physical filing systems to maintain organization and accessibility of records.
- Increased filing productivity by implementing a structured organization system. by implementing systematic organization.
- Conducted research on diverse topics and summarized findings into clear reports.
- Condensed complex information into straightforward reports for improved understanding.
Customer Service & Account Support | Data Entry & Administrative Coordination
Maximus
Remote
10.2017 - 11.2018
- Facilitated timely and precise responses to customer inquiries, assessed account details to troubleshoot issues, and implemented effective solutions.
- Resolved 95% of customer inquiries on first contact.
- Improved customer satisfaction ratings by 20% through effective communication.
- Maintained professionalism during escalated situations, effectively de-escalating customer concerns to restore satisfaction.
- Recorded customer interactions comprehensively for tracking requests and resolutions.
- Managed approximately 20 inbound and outbound calls daily to resolve claim issues and deliver timely customer support.
- Processed 50-80 benefit verifications daily, consistently meeting productivity requirements while ensuring high accuracy and quick turnaround.
- Utilized RxConnect, CoverMyMeds, Availity, and Microsoft 365 to verify benefits, resolve insurance eligibility issues, and coordinate claim processing.
- Streamlined documentation processes to improve tracking accuracy and reduce processing time.
- Ensured 100% accuracy in data transcription and verification.
- Eliminated data entry discrepancies, maintaining system integrity.
- Facilitated smooth communication through professional document translation.
Education
High School Diploma -
Fairfield High School
Fairfield, CASkills
- Benefits Verification
- Claims Adjudication
- Insurance Eligibility
- Prior Authorization
- Availity
- RxClaim
- Commercial Insurance
- Medicaid
- Medicare
- Medical Terminology
- HIPAA
- Microsoft Excel
- Outlook
- CRM Systems
- Remote Collaboration
- SharePoint
- Customer Resolution
Timeline
Benefits Verification Specialist
CVS Specialty Pharmacy
09.2021 - 03.2026
Freelance Audio Engineer (Part-Time)
Self-Employed
03.2020 - 09.2021
Administrative & Media Production Support
Must Amplify
12.2018 - 02.2020
Customer Service & Account Support | Data Entry & Administrative Coordination
Maximus
10.2017 - 11.2018
High School Diploma -
Fairfield High School