Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Taquana Mosley

Frisco,TX

Summary

Collaborative individual with expertise in providing exemplary service regarding benefits support. Multitasking Benefits Specialist knowledgeable in state and federal regulations and maintaining employee confidentiality. Self-motivated Benefits Specialist demonstrating superior understanding of employee benefits laws and human resource software systems. Astute professional providing benefits support in fast-paced corporate settings. Strategic consultant eager to leverage knowledge in payroll and tax laws. Skilled in using data and analytics to evaluate job duties and requirements. Qualified to implement compensation and benefits strategies. Reliable and committed to professional development and growth. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level [Job Title] position. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Top-notch professional with extensive experience in job analysis and job evaluation. Skilled in conducting salary surveys and implementing compensation and benefits plans. Collaborative and committed to staying updated on best practices.

Overview

2
2
years of professional experience
1
1
Certification

Work History

Benefits Verification Specialist

TEK Systems Global Services
10.2023 - Current
  • Enhanced claim processing efficiency by reviewing and verifying insurance benefits information.
  • Streamlined workflow for benefit verification team by implementing a comprehensive data tracking system.
  • Reduced errors in benefit verification tasks by conducting thorough audits and rectifying discrepancies.
  • Assisted clients with resolving complex benefits issues, improving overall customer satisfaction.
  • Optimized the use of electronic claims submission systems to expedite claim processing times.
  • Collaborated with healthcare providers to ensure accurate billing and benefit coverage information.
  • Expedited appeals process for denied claims through meticulous preparation of supporting documentation and adherence to timelines.
  • Maintained up-to-date knowledge on industry regulations, ensuring compliance throughout all benefit verification processes.
  • Established positive relationships with insurance carriers, streamlining communication channels when clarifying policy details or negotiating terms on behalf of clients.
  • Provided support during open enrollment periods by answering questions about plan changes, adjustments, or renewals from both existing and prospective clients alike.
  • Increased accuracy in verifying patient eligibility through diligent cross-checking of multiple databases before finalizing claim submissions.
  • Researched and evaluated new benefits programs to select cost-effective providers and coverage levels.

Patient Access Representative

Emerus Health Inc.
05.2023 - Current
  • Streamlined patient registration processes by implementing efficient data collection methods and reducing wait times.
  • Improved patient satisfaction scores by actively addressing concerns and providing prompt assistance during the check-in process.
  • Enhanced overall patient experience with empathetic communication and thorough explanations of insurance benefits and coverage.
  • Maintained accurate patient records, contributing to a well-organized database for seamless information access across departments.
  • Increased efficiency in managing high call volumes by developing effective phone triage techniques for prioritizing urgent matters.
  • Collaborated with healthcare providers to ensure timely appointment scheduling and coordinated follow-up care for patients'' needs.
  • Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
  • Assisted with administrative tasks such as filing, data entry, and report generation to support streamlined office operations.
  • Trained new hires on department procedures, policies, and software systems, ensuring consistent quality service delivery from all team members.
  • Contributed to a positive work environment by fostering strong relationships among colleagues, promoting teamwork, and sharing best practices.
  • Supported medical staff by coordinating diagnostic testing appointments, lab results retrieval, and necessary referrals in a timely manner.
  • Managed challenging situations effectively by remaining calm under pressure while resolving conflicts or addressing dissatisfied patients professionally.
  • Developed proficiency in various healthcare software programs for accurate documentation of patient encounters and streamlined workflows within the department.
  • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
  • Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
  • Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
  • Providing excellent customer service by promptly answering patient inquiries.
  • Greeted and assisted patients with check-in procedures.
  • Verified patient insurance eligibility and entered patient information into system.
  • Provided excellent customer service to patients and medical staff.
  • Compiled and maintained patient medical records to keep information complete and up-to-date.
  • Facilitated communication between patients and various departments and staff.
  • Engaged with patients to provide critical information.
  • Organized patient records and database to facilitate information storage and retrieval.
  • Trained new staff on filing, phone etiquette and other office duties.
  • Applied administrative knowledge and courtesy to explain procedures and services to patients.

Benefits Care Manager

IQVIA
12.2022 - 05.2023
  • Enhanced patient care by developing and implementing individualized care plans.
  • Improved patient satisfaction through effective communication and collaboration with interdisciplinary healthcare teams.
  • Reduced hospital readmission rates by providing comprehensive discharge planning and follow-up support.
  • Streamlined care coordination processes, resulting in timely referrals and access to appropriate resources.
  • Managed complex caseloads, ensuring timely assessment, intervention, and documentation for optimal care outcomes.
  • Facilitated family meetings to address concerns, establish goals of care, and provide psychosocial support.
  • Collaborated with insurance providers to secure authorization for necessary services, maximizing patients'' benefits coverage.
  • Utilized electronic health records systems proficiently for efficient documentation of clinical information according to regulatory standards.
  • Evaluated program effectiveness using quality indicators such as patient satisfaction surveys and outcome measures data analysis results.
  • Served as a liaison between patients, families, physicians, insurance providers, and other healthcare professionals for seamless care coordination efforts.
  • Maintained up-to-date knowledge of community resources by networking with local organizations and attending professional development opportunities.
  • Communicated with healthcare providers to facilitate continuity of care.
  • Maintained detailed records in compliance with agency standards and regulations.
  • Coordinated referrals to specialists, hospitalizations, ER visits, ancillary testing, and other enabling services for patients.
  • Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
  • Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
  • Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.

Pharmacy Care Coordinator

AmerisourceBergen
11.2021 - 11.2022
  • Enhanced client satisfaction by providing prompt and accurate information regarding specialty benefit plans.
  • Streamlined benefits enrollment process for clients, ensuring smooth and efficient onboarding.
  • Increased team efficiency through regular training sessions on new products, industry trends, and best practices in benefits coordination.
  • Developed strong relationships with clients, resulting in increased retention rates and high levels of customer satisfaction.
  • Ensured compliance with all federal, state, and local regulations governing employee benefit programs administration.
  • Managed a diverse portfolio of accounts while consistently meeting or exceeding performance metrics tied to client satisfaction, retention, and revenue generation.
  • Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
  • Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
  • Implemented open enrollment system to streamline benefits processes for employees.
  • Developed comprehensive benefits packages to improve employee satisfaction and retention.

Education

No Degree - Certifications

PrimaCare
02.2023

GED -

Moises E Molina High School
Dallas, TX
05.2004

Skills

  • Policy Interpretation
  • Accuracy and Precision
  • Healthcare regulations
  • Proficient in Microsoft
  • Benefits Explanation
  • Documentation And Reporting
  • Employment law knowledge
  • Termination Procedures
  • Written and oral communication
  • Relationship Building
  • Benefits Administration
  • Verbal and written communication
  • Analytical Skills
  • Professional Demeanor
  • Time Management
  • Professionalism
  • Organizational Skills
  • Problem-Solving
  • Multitasking
  • Adaptability and Flexibility
  • Analytical Thinking
  • Written Communication
  • Teamwork and Collaboration
  • Attention to Detail
  • Interpersonal Communication
  • Excellent Communication

Certification

  • Licensed Medical Aesthetician
  • Certified Medical Assistant

Timeline

Benefits Verification Specialist

TEK Systems Global Services
10.2023 - Current

Patient Access Representative

Emerus Health Inc.
05.2023 - Current

Benefits Care Manager

IQVIA
12.2022 - 05.2023

Pharmacy Care Coordinator

AmerisourceBergen
11.2021 - 11.2022

No Degree - Certifications

PrimaCare

GED -

Moises E Molina High School
Taquana Mosley