Summary
Overview
Work History
Education
Skills
Timeline
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Pamela Bayhan

Lansing,MI

Summary

Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.

Overview

30
30
years of professional experience

Work History

Eligibility Analyst

CVS/Caremark/Meritain Health
05.2024 - Current
  • Evaluate and process eligibility applications for health insurance coverage in compliance with federal, state, and organizational guidelines.
  • Analyze enrollment data to ensure accuracy and resolve discrepancies related to member eligibility, coverage status, and benefits.
  • Collaborate with internal departments, third-party administrators, and external agencies to verify applicant information and maintain data integrity.
  • Utilize health plan systems and databases to update, track, and monitor eligibility records and transactions.
  • Respond to inquiries from brokers, employers and members regarding eligibility issues, offering timely and accurate resolutions.
  • Mentor new team members on eligibility processes, systems, and compliance standards to ensure a high-performing and knowledgeable team.
  • Assist clients with accurate eligibility form, application and document completion.
  • Assist with day-to-day operations, working efficiently and productively with all team members.
  • Maintain strict adherence to HIPAA regulations and company confidentiality policies in all aspects of data handling.

Assistant Supervisor/Quality Control

Extend Your Reach
09.2012 - 05.2024
  • Ensured customers were satisfied with the level of service offered.
  • Helped ensure compliance with company, HIPAA, and USPS policies and regulations.
  • Inspected mail pieces for consistency with quality standards, including packaging, labeling, and functionality.
  • Oversaw a team of five to ten and delivered training on internal QC processes, and provided continual mentorship.
  • Operated high speed sorting machines to prepare mail for delivery.
  • Maintained clean and well-organized production areas to avoid violations or unnecessary work delays due to hazards or inefficient layouts.
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Submitted documentation and reports to upper management.
  • Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
  • Developed detailed plans based on broad guidance and direction.

Package Handler/Delivery Driver

UPS
09.1995 - 04.2010
  • Collaborated with team to maximize delivery efficiency in a fast-paced, high-volume work environment.
  • Optimized route planning during high-volume business days to reduce delays.
  • Maintained cleanliness of company vehicles, alerted management to potential issues, and ensured compliance with traffic regulations at all times.
  • Demonstrated in-depth knowledge of over 30 delivery routes.

Education

Some College (No Degree) - Creative Writing

Lansing Community College
Lansing, MI

Skills

  • Attention to detail
  • Effective communication/writing skills
  • Creates positive work relationships
  • Applies critical thinking in fast-paced circumstances
  • Policy Interpretation
  • Recordkeeping and data input
  • Eligibility procedures
  • Mentorship and training
  • Over 25 Years Experience in a Logistics Environment

Timeline

Eligibility Analyst

CVS/Caremark/Meritain Health
05.2024 - Current

Assistant Supervisor/Quality Control

Extend Your Reach
09.2012 - 05.2024

Package Handler/Delivery Driver

UPS
09.1995 - 04.2010

Some College (No Degree) - Creative Writing

Lansing Community College

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Pamela Bayhan