LiveCareer-Resume

benefits administrator assistant der resume example with 8+ years of experience

Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
:
Summary

Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Hardworking and reliable Benefits Administrator with strong ability to relate to employees and there needs. Highly organized, proactive and punctual with team-oriented mentality.

Skills
  • Enrollment Coordination with deductions understanding
  • HR and Leadership Experience
  • Planning & Organizing
  • Friendly, Positive Attitude and Team Player
  • Critical Thinking
  • Good Work Ethic
  • Supervision & leadership
Education and Training
Tellico Plains High School Tellico Plains, TN, Expected in 05/2002 High School Diploma : - GPA :
University of Tennessee Chattanooga, TN, Expected in : Education and Business Management - GPA :
Experience
Utah Transit Authority - Benefits Administrator, Assistant DER
City, STATE, 06/2022 - Current
  • Oversee enrollment of new employees monthly, transfers, life events and recently attended first company-wide enrollment period.
  • Facilitate biweekly new employee benefit education and show enrollment tools to help them succeed.
  • Maintain employee benefits programs and informed employees of benefits by studying and assessing benefit trends.
  • Checked accuracy and completeness of benefits applications documents.
  • Analyzed employment-related data and prepared reports to be more efficient.
  • Researched employee benefit for health and safety practices, recommending changes or modifications to existing policies.
  • Answered incoming calls and recorded accurate messages.
  • Served as contact person and source of information to maintain good communication with employees.
  • Administrator to education reimbursement program. That helped employees best utilize and grow within program.
  • Work with payroll and HRBPs, on records for education program.
  • Maintained positive working relationship with fellow staff and management.
  • Assisted Head DER, with all drug and alcohol policy's and procedures.
  • Attended meetings for D&A related cases, facilitate when needed.
  • Attended several trainings, local and nationwide on subject matter, Learning regulations both state and federal.
  • Also helped with record keeping and attended FRA audit.
EMI Health - Claims Supervisor and Dental Supervisor
City, STATE, 02/2019 - 06/2022
  • During this time as dental supervisor, won crystal apple award.
  • Evaluated and motivated employees to continuously develop and grow in both performance and knowledge.
  • Recommended and communicated goals to help team excel against targets.
  • Streamlined processes to be more efficient updated training documents and created policies and procedures.
  • Oversaw daily workload for dental team, claims team, queues, appeals, and special projects.
  • With these small changes allowed turnaround time from 15.8 days to 5.7-day turnaround on claims processing.
  • Held weekly one on ones, to go over work but also home life balance.
  • Motivated team members to maintain targeted turnaround time to obtain processing goals.
  • Oversaw onboarding processes for new team members, delivering training on claims handling.
  • Collaborated with quality team regarding quality assurance reviews.
  • Investigated sensitive customer service complaints and delivered prompt resolution to customer satisfaction.
  • Collaborated with management team to implement new work procedures or policies.
  • Made sure state and federal laws are being followed within all exchange products and states.
  • Make sure that all ADA codes are updated, and benefits assigned correctly.
  • Worked with groups, marketing team on how to have better understanding of benefits to best suit members, groups, brokers, and companies.
EMI Health - Customer Service Member and Claims Editor
City, STATE, 02/2017 - 02/2019
  • Answer phones in timely professional matter and showed empathy.
  • Responded to phone and online customer service requests within designated turnaround time to improve customer satisfaction ratings.
  • Had special clearance to do employee verification and benefits calls.
  • Be willing to help coworkers, and not give up until problems are solved.
  • Mark sure that claims are processed or reprocessed according to state, and federal regulations
  • Have thorough understanding of CPT, HCPCS, IC9/ICD 10.
  • Efficient with 10-key, Excel, Word, PDF, Zoom, Microsoft teams, PowerPoint, Outlook, ADP, Paycom, Javalina products and HUB
  • Processed EMI employee claims, medical, dental, vision, Medicare claims.
  • Processed dental claims, predeterminations, worked with P&R dental strategies, DDMAX, Careington, Cigna, and other outside dental contracting
  • Worked with provider team, customer service training, plan build and configuration
  • Started working with compliance on creating and updating policies to make sure teams followed state/federal regulations.
  • Processed all dental claims, predeterminations, dental COB, appeals, fast tracks and editing claims.
  • Worked with supervisors, and department head on better more efficient ways to do claim processing.
  • Helped with office moral and cohesion with staff members.
  • Looked for ways to help advocate for members, patients, providers and company, when it comes to finding fraudulent treatment.
Draper Smiles - Office Manager and Lead Dental Assistant
City, STATE, 10/2014 - 01/2017
  • Was hired as floater from that to front office and second assistant.
  • Maintained impeccable office organization to support efficiency, professionalism and performance objectives.
  • Monitored payments due from clients and promptly contacted clients with past due payments.
  • Managed office inventory and placed new supply orders.
  • Administered payroll and maintained proper documentation of employee personnel.
  • Coded and entered daily invoices with in-house accounting software.
  • Such duties as scheduling, insurance issues, coding, insurance breakdowns, billing, financial arrangements, and everyday customer relations.
  • In charge of timecards, vacation schedules, and disciplinary write ups.
  • Answered phones, emails, automated computer systems, faxing and coping also help with implementations of different policies and procedures to be more efficient.
  • Proficient in Eaglesoft, Revenue well, Dropbox, Excel, Word, Carestream imaging, prosuni imaging, also do scanning daily.
  • Provided chair-side assistance during dental examinations and procedures to boost efficiency and calm nervous patients.
  • Laid out dental instruments and equipment before procedures.
  • Took bitewing, periapical, panoramic and occlusal X-rays and prepared for dentists to review.
  • Utilized automated washers to sterilize instruments and prevent cross-infection between patients.
  • Entered patient data into dental records system and observed confidentiality rules to maintain patient privacy.
  • Gathered and reviewed patient records, data and health history to share with dentists for quick and accurate patient assessments, diagnoses and treatment.
  • Built loyal patient following and retained return patients by providing empathetic and caring service.
  • Educated patients on techniques to optimize oral hygiene, control plaque and protect teeth and gums.

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Resume Overview

School Attended

  • Tellico Plains High School
  • University of Tennessee

Job Titles Held:

  • Benefits Administrator, Assistant DER
  • Claims Supervisor and Dental Supervisor
  • Customer Service Member and Claims Editor
  • Office Manager and Lead Dental Assistant

Degrees

  • High School Diploma
  • Some College (No Degree)

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