Employee Navigator
Hi, I’m
Toni Blaylock
Benefit Specialist
McDonough,GA
Summary
Proven Eligibility Specialist, adept in leveraging and effective communication to enhance client satisfaction and streamline processes. Demonstrated success in reducing errors by implementing continuous improvement strategies, achieving a significant increase in efficiency. Skilled in teamwork and problem-solving, consistently delivering empathetic service and precise eligibility determinations. Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Overview
5
years of professional experience
Work History
Assured Partners
Employee Benefits Eligibility Specialist
11.2022 - Current
Job overview
- Assisted clients with accurate eligibility form, application and document completion.
- Communicated with people from various cultures and backgrounds on application process.
- Processed and certified documents for accuracy and compliance with government regulations.
- Established databases to track, analyze and automate eligibility application processes.
- Resolved discrepancies with client applications to verify eligibility.
- Trained staff on current eligibility requirements and policies.
- Enhanced client trust and relations by consistently providing empathetic and respectful service during eligibility determination process.
- Facilitated smooth transitions between program stages by coordinating closely with internal departments and external partners as needed.
- Provided exceptional customer service through prompt response times, clear communication channels, and diligent follow-up practices.
- Enhanced public understanding of eligibility criteria by creating and distributing informative brochures and materials.
- Kept current on industry trends and best practices through ongoing professional development activities, ensuring continued excellence in service delivery.
- Reduced errors in eligibility determination by conducting regular audits and feedback sessions for continuous improvement.
- Increased efficiency in the review process by proactively identifying potential issues and developing actionable solutions.
- Leveraged advanced technology tools to streamline data entry tasks while minimizing human error rates.
- Improved client satisfaction with prompt and precise communication regarding eligibility status and benefits information.
McKesson
Patient Service Specialist
10.2019 - 11.2022
Job overview
- Liaise with the patient, insurer and physician regarding the documentation required for maximum reimbursement coverage, including the exploration of all public and private insurers and providing employer escalations as required
- Conduct information and conduct patient financial assessment eligibility based on program guidelines
- Provide responses to general inquiry calls based on information provided as part of the program materials
- Coordination with Specialty and Retail pharmacies to ensure that the patient has access to the required treatment
- Proactively monitor the patient's file to ensure that reimbursement and financial assistance renewals are done in a timely manner
- Process documents supporting the patient's care, including infusion reports, lab results, copays
- Receive, record and report Adverse Events as per the Pharmaceutical Manufacturer requirements
- Participate and assist in departmental continuous improvement activities related to process, quality, training, etc
- Maintain service levels in case management, including telephone answer rates, time to initial contact with the patient
- Perform data-entry, answer inbound calls, make outbound calls, manage e-mail and fax software, general administrative functions including faxing, filing.
Education
Wayne County Community College DistrictDetroit, MI
Associate of Applied Science from Business Administration And Management
05.2001
University Overview
- Honoree class Manga Cum laude
- Honor Roll
- GPA 3.8
Skills
Effective communication skills
Microsoft Office
Documentation and paperwork
Data Entry
HIPAA certified
Documentation And Reporting
Benefits Administration
Knowledgeable in Employee Navigator
Proficiency in using multiple screens
Telephone Etiquette
Teamwork and Collaboration
Problem-Solving
Software
Flipsnack Digital Creator
ACT Database
CIS
ECIN
CHAMPS
HubServices
Timeline
Employee Benefits Eligibility Specialist
Assured Partners
11.2022 - Current
Patient Service Specialist
McKesson
10.2019 - 11.2022
Wayne County Community College District
Associate of Applied Science from Business Administration And Management
05.2001