Eboni King

Patient Access Case Management Professional with 7+ years of experience in healthcare benefits verification, prior authorizations, patient support services, and provider services. Proven ability to manage complex patient cases, navigate payer requirements, and secure timely access to therapies. Strong expertise in insurance workflows, CRM documentation, and cross-functional collaboration to support patient outcomes.

Case Management Specialist, Rare Diseases – Tzield - Sanofi Pharmaceuticals - Charlotte, NC (Remote)

(2023-08)

Manage a high-volume caseload of 40+ concurrent cases, leading the case management process with urgency and purpose while prioritizing acuity, timelines, compliance requirements, and balancing individual patient needs with organizational business objectives.

• Assess patient access needs, developed treatment initiation/continuation plans, and facilitated insurance approvals for rare disease therapies.
• Educate patients, caregivers, and healthcare providers on insurance options, requirements, limitations, and approval processes.
• Maintain expert knowledge of reimbursement procedures, payer trends, billing/coding protocols, and patient assistance resources.
• Enroll qualified patients into financial assistance programs, ensuring ongoing therapy access.
• Apply up-to-date regional resources and market knowledge to improve patient access outcomes.
• Coordinate compliant exchange of patient information with internal and external stakeholders.
• Identify complex patient-specific challenges, created actionable solutions, and ensured execution with measurable results.
• Build and maintain strong relationships with cross-functional teams, insurers, specialty pharmacies, and clinical site staff.
• Represent the organization at patient meetings, site visits, conferences, and trade shows.
• Contribute to team growth by sharing reimbursement expertise, training peers, and supporting complex case reviews.
• Maintain precise documentation of insurance coverage, approvals, requirements, and all interactions.
• Leverage CRM tools and data analytics for strategic territory planning and prioritization.
• Provide territory coverage as needed while ensuring compliance with all policies.

Insurance Verification Specialist - Provention Bio – A Sanofi Company - Charlotte, NC

(2023-04 - 2023-08)

• Conducted comprehensive benefit verification for patients, including cost share and coverage limitations.
• Documented insurance plan details, provider options, and prior authorization requirements.
• Investigated payer processes for prior authorizations, appeals, and peer-to-peer reviews.
• Identified access barriers and escalated issues to appropriate internal teams.
• Completed quality reviews and maintained accurate Salesforce CRM documentation.
• Communicated updates and trends to team via Microsoft Teams and CRM collaboration tools.

Customer Service Specialist (Provider Services) (Contract Role) - Epiq Systems - Charlotte, NC

(2022-11 - 2023-03)

• Assisted healthcare providers by verifying eligibility and claim status.
• Reviewed paid, pending, and denied claims and explained denial codes.
• Provided guidance on claims submission and appeals processes.
• Escalated complex issues to claims department and supported dispute inquiries.

Contact Center Representative II (Class Action / Remediation / Special Cases) (Contract Role) - Epiq Systems - Charlotte, NC

(2022-08 - 2022-10)

• Managed inbound/outbound calls, emails, and chat support for specialized case work.
• Resolved customer inquiries and escalated complex issues as needed.
• Performed data entry, research, and documentation for case records.

Billing Account Specialist - Charter Communications Spectrum - Charlotte, NC

(2021-05 - 2022-06)

• Provided first call resolution for billing and account inquiries.
• Processed payments, adjusted services, and resolved billing disputes.
• Ensured accurate documentation and customer confidentiality.

Marketing – Circulation Administrative Coordinator & Customer Service Rep - American City Business Journals - Charlotte, NC

(2019-03 - 2021-01)

• Provided customer support for subscriptions, orders, and billing.
• Managed order fulfillment and payment processing.
• Maintained customer database and invoicing records.
• Upsold products and supported sales initiatives.

Seasonal Benefits Verification Specialist (Contract Role) - AmerisourceBergen, Lash Group

(2017-10 - 2019-02)

• Conducted benefit verification with private and public healthcare payers.
• Verified medical benefits and updated patient insurance profiles.
• Followed up with payers for re-verification and resolved discrepancies.
• Submitted documentation and ensured accurate patient benefit records.

Customer Service Associate (Contract Role) - Duke Energy - Charlotte, NC

(2018-03 - 2018-07)

• Handled inbound calls and resolved billing/credit inquiries.
• Managed account updates, service requests, and payment arrangements.

Customer Service Specialist (Provider Services) (Contract Role) - Conduent - Charlotte, NC

(2017-05 - 2017-10)

• Assisted providers with insurance benefits and claims research.
• Verified policy details and resolved provider inquiries.

Customer Service Healthcare Professional (Contract Role) - Aon Hewitt Associates - Charlotte, NC

(2017-01 - 2017-04)

• Assisted employees with benefits enrollment and healthcare plan questions.
• Verified coverage and explained plan options and networks.

Bachelor of Science - Kinesiology - University of Tennessee (2013-12)

High School Diploma - Ridgeway High School