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benefit program specialist resume example with 10 years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Professional Summary

Benefits Specialist dedicated to assisting employees with open enrollment for smooth and simple process. Offering more than 5 years of documenting and reporting changes in relation to benefits. Composed, talented and considered effective team player.

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.

Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results.

Astute inbound/outbound call professional offering polished communication skills. Brings excellent organizational skills and talent for overcoming customer objections. Self-motivated and true team player.


Knowledgeable and dedicated customer service professional with extensive experience. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.

Skills
  • Benefits explanation
  • Proficient in Word Processor, Microsoft Word, Web Browser, MS Excel, Adobe, Fax, Meds, Spreadsheet, MS Outlook, OneDrive, Google Docs, Office 365, MS Powerpoint
  • Written and oral communication
  • Regulatory monitoring
  • Documentation and reporting
  • Team building
  • Training and Development
  • Excellent Communication
  • Multitasking Abilities
  • Dependable and Responsible
  • Flexible and Adaptable
  • Good Telephone Etiquette
Work History
Benefit Program Specialist, 07/2016 to Current
Capital Senior LivingCleveland, OH,
  • Mississippi Medicaid State Agency Hours per week: 40
  • Eligibility
  • Conduct agency-wide risk assessments for purposes of preparing and quality assurance of Medicaid eligibility documentation
  • Assists in investigations and management reviews to improve internal controls, ensure compliance with laws, rules, and policies
  • Enhance the effectiveness of the Agency's Medicaid eligibility systems, and processes for detecting and preventing fraud
  • Perform preliminary reviews to assess the greatest risk within programs, activities, or functions
  • As a Medicaid specialist, with the Division of Medicaid, I present eligibility report layouts to reveal findings, methods of analyzing income data, and maintain account receivables
  • As a Medicaid Specialist within the Mississippi Division of Medicaid, I have conducted daily, weekly, monthly, and quarterly analysis of national health insurance program policy issues in order to propose policy modifications
  • Developed regulations, manuals, program guidelines, program memoranda, policy letters, and/or instructions to communicate health insurance program policies
  • I have presented recommendations and conclusions based on analysis and evaluation of health insurance programs that describe feasible options and/or the consequences
  • Represent the Agency in discussions and events regarding Medicaid or CHIP program integrity policy
  • Write, review, and edit documents (e.g., regulations, policy guidance, issue papers, briefing papers and reports) on Medicaid/CHIP policy issues relating to quality measurement and improvement to support managed care policy and/or emerging initiatives
  • Encourage and empower staff to participate in training and develop training opportunity to enhance their career development
  • Implements new or cutting edge programs to improve operations
  • Process annual redeterminations for Medicaid clients that are associated with Health Plans, Long Term Care and Aged Blind and Disabled category cases
  • Generate letters and make follow up calls requesting confidential information to determine Medicaid client’s health plans, spend down, and co-payments by calculating house hold size, income and assets by the Federal Poverty Levels
  • Report suspected fraud cases to the Medicaid Fraud Control Unit
  • Effectively handles active phone calls, determining the identity of the caller, obtaining needed information, and responding to caller inquiries
  • Managed customers' database accounts by performing customer verifications and processing benefit enrollments.
  • Interviewed prospective clients to obtain data regarding financial resources and needs and physical conditions of insured.
  • Performed administrative tasks such as maintaining records and handling policy renewals for over 100 clients.
Waitstaff , 04/2014 to 01/2016
Bristol FarmsSanta Monica, CA,
  • Practiced safe, sanitary food handling for preparation and service to maximize pleasant dining experience.
  • Explained menu items and preparation methods to provide high level of customer service and promote dining atmosphere.
  • Set up dining room to promote welcoming environment and meet or exceed hospitality and service standards.
  • Assisted in food preparation as directed while following instructions to meet specific dietary needs.
  • Leveraged knowledge of table clearing techniques such as napkin folding and refilling condiments to reset table during and after dining service.
  • Cultivated warm relationships with regular customers.
  • Bussed and reset tables to keep dining room and work areas clean.
  • Arranged and prepared tables for customers to offer memorable experiences to guests and foster repeat business.
  • Increased sales by 10%
Cashier, 07/2011 to 12/2012
Avalon Health Care GroupIvins, UT,
  • Operated cash register for cash, check and credit card transactions with excellent accuracy levels.
  • Worked flexible schedule and extra shifts to meet business needs.
  • Helped customers complete purchases, locate items and join reward programs.
  • Restocked and organized merchandise in front lanes.
  • Answered questions about store policies and addressed customer concerns.
  • Promoted customer loyalty and consistent sales by delivering friendly service and knowledgeable assistance.
  • Collected and authorized payments of guests.
  • Maintained secure cash drawers, promptly resolving discrepancies in daily totals.
  • Checked identification for proof-of-age for alcohol and tobacco sales.
Certified Nurse Assistant, 01/2010 to 03/2011
Copiah LivingCity, STATE,
  • Center Hours per week: 40
  • Patient Care
  • Dedicated and compassionate Certified Nursing Assistant with proven communication, analytical and time-management skills gained during clinical training in a fast-paced
  • Experienced and reliable CNA with proven patient care and documentation skills seeking a position in neonatal care
  • Initiated, performed, and completed assigned duties in providing care to variable patient populations
  • Maintained good communication with Nurse Manager, nursing staff, and other facility staff
  • Communicate and interact appropriately and courteously with internal and external customers
  • Maintained a working knowledge of all policies and procedures pertaining to the position
  • Participated in orientation and training
  • Made environmental and safety rounds
  • Made rounds to check on all patients
  • Performed other duties as assigned by the Nurse Manager or charge nurse
  • Communicated orally with patients, families, interdisciplinary team and other personnel
  • Facilitated personal hygiene management, feeding and ambulation.
  • Maintained patient stability by checking vital signs and weight and recording intake and outtake information.
Education
60 Credit Hours: Business Administration, Expected in to Holmes Community College - Ridgeland, MS,
GPA:
Technical Diploma: Medical Office Assistant , Expected in 01/2013 to Allied Health Institute - Fort Lauderdale,
GPA:
Additional Information
  • SELECTED AWARDS SELECTED PUBLIC SPEAKING , Performance Award Administrator Special Citation Award – National Medicaid Audit Program Employee of the Month

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Resume Overview

School Attended

  • Holmes Community College
  • Allied Health Institute

Job Titles Held:

  • Benefit Program Specialist
  • Waitstaff
  • Cashier
  • Certified Nurse Assistant

Degrees

  • 60 Credit Hours
  • Technical Diploma

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