TONI BLAYLOCK
Benefit Specialist
McDonough,GA
Summary
Results-driven Benefit Specialist known for productive and efficient task completion. Possess specialized skills in benefits administration, regulatory compliance, and employee relations management. Excel in communication, problem-solving, and adaptability, ensuring smooth operation of benefits programs and high levels of employee satisfaction.
Overview
13
13
years of professional experience
Work History
Eligibility Benefit Specialist
Assured Partners
Scottsdale, AZ
11.2022 - 11.2024
- Handle enrollment, terms and data changes of 22 companies and 1700+ employees
- Import active employees’ demographic data, salary, and personal information into Employee Navigator data integration system
- Communicate with carriers daily regarding enrollment discrepancies and billing issues
- Train HR Administrators and Benefit Coordinators on how to use Data Integration System and how it can benefit and organize their HR records
- Strong knowledge in medical, dental, vision, and ancillary benefits
- Create and use Microsoft Excel spreadsheets to track data, analyze and automate enrollment application process
- Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices
- Responsible for drafting and assembling client communications letters, emails, and benefit guidebooks; assist and offer guidance with employee benefits and other employee-benefits related projects
Patient Service Specialist
McKesson
Scottsdale, AZ
10.2019 - 11.2022
- Collected and verified patients' drug coverage for specialty medications with Medicare, Medicaid, and commercial carriers.
- Obtained payer-specific prior authorization procedures and required documentation to assist case managers on how to assist the client and healthcare provider with the prior authorization process.
- Conducted benefit coverage calls with policyholders to obtain verbal consent to verify coverage information on their behalf.
- Processed information for claims, explained out-of-pocket costs, Medicare coverage per tier, and state coverage for Medicaid recipients.
- Able to navigate multiple computer screens and tabs to retrieve and enter data.
- Applied HIPAA privacy and security regulations while handling patient information.
Insurance Specialist
McKesson
Scottsdale, AZ
12.2018 - 10.2019
- Verified pharmacy coverage with Medicare, Medicaid and commercial carriers
- Entered all insurance and demographic data in HUB Services data integration system
- Submitted detail documents, financial information, prescription coverage to pharmaceutical corporations for financial assistance for life saving medications
- Investigated denied prior authorizations and provide healthcare providers with what is needed for resubmission of the prior auth for approval
- 80% ratio of turning denied prior authorizations into approvals
Facility Admissions Coordinator
Novi Extended Care and Rehab
Novi, MI
01.2015 - 06.2018
- Completed preliminary paperwork for incoming and outgoing patients
- Collaborated with admissions team to develop and implement strategies to improve admissions process
- Verified patients' insurance benefits to meet the standards for admission policy
- Supervised and welcomed new patient’s admissions into the facility
- Marketed and meet with medical facility directors, and other entities on how the facility can meet their patient’s extended care needs after discharge
- Collaborated with several departments to plan monthly events and outings for patients and staff
Patient Care Liaison
Haper Hospital
Detroit, MI
06.2011 - 10.2014
- Communicated patient’s needs emotionally, physically, socially and financially to necessary depts
- Presented resolutions to issues patients experienced during their treatment and stay at the hospital by investigating and analyzing all facts
- Composed reports on patient/family satisfaction or dissatisfaction
- Meet with facility directors, managers and healthcare professionals of my investigative findings and how a resolution can be met
- Responsible for tracking follow-up surveys for discharged patients and presented the data on spreadsheets and graphs to the administrative board for new practices and procedures to be implemented
- Assisted staff with other duties as needed
Education
Certificate - Business Administration
Wayne County Community College
Detroit, MI02.1997
Certificate - Medical Assistant
Institute of Medical & Business Careers
Pittsburgh04.1987
High School Diploma -
Frank Cody High School
Detroit, MI06.1984
Skills
- Microsoft Office Suite
- Employee Navigator
- ACA filing
- ECIN
- Point Click Care
- Excel
- ICD-9 Codes
- Call Center Experience
- Front Office
- HubServices
- Hubble
- Customer Service
- Inbound & Outbound calling
- Teams
- Outlook
- Medical Terminology
- COBRA Enrollment
- PowerPoint
- Life insurance
- Benefits administration
- Benefits communication
- HIPAA compliance
- Client Facing Skills
- Healthcare Benefits
- Open enrollment
- Slack
- Okta
References
References available upon request.
Languages
English
Native language
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
RemoteImportant To Me
Work-life balanceHealthcare benefitsPersonal development programsWork from home optionPaid time off401k matchCompany CultureFlexible work hoursPaid sick leaveTeam Building / Company RetreatsStock Options / Equity / Profit SharingCareer advancementSoftware
Microsoft
Employee Navigator
Point Click Care
HubServices
Slack
FlipSnack
Okta
Excel
Teams
Outlook
PowerPoint
BenefitPoint
Interests
Party Planning
Interior Decorating
Volunteering
Timeline
Eligibility Benefit Specialist
Assured Partners
11.2022 - 11.2024
Patient Service Specialist
McKesson
10.2019 - 11.2022
Insurance Specialist
McKesson
12.2018 - 10.2019
Facility Admissions Coordinator
Novi Extended Care and Rehab
01.2015 - 06.2018
Patient Care Liaison
Haper Hospital
06.2011 - 10.2014
Certificate - Business Administration
Wayne County Community College
Certificate - Medical Assistant
Institute of Medical & Business Careers
High School Diploma -
Frank Cody High School
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