Experienced Benefits Administrator seeking Insurance Verification Specialist Position, capable of working with providers, establishing client rapport and coordinating benefits. Solid understanding of documentation, recordkeeping and compliance requirements. Ready to bring organizational, problem-solving and relationship-building skills developed over a 10+year's career to a challenging new role.
• Primary Benefits Administrator for 250+ lives
• Coordinated and tracked all FMLA for employees throughout USA
• Audited and secured all dependent verification forms: marriage certificates, Birth Certificates, Certificate of insurance, and social security numbers for insurance enrollments.
• Managed, coded and processed all employee medical and dental claims
• Responsible for collecting over $28,000 in company claims after identifying system error
• Counseled employees regarding claim payments, co-pays, and EOB explanations
• Liaison between insured and third-party administrator to assure claims were paid correctly and promptly.
• Paid and tracked all monthly billing for company responsible insurance plans
• Prepared and communicated to employees all insurance updates and policy reminders through company newsletter
• Set up payment plans with employee doctors/hospitals
• Prepared and processed all paperwork regarding escalated claims to external Vendors for review process
• Partnered with IT department to integrate company IT system with HRIS
• Coordinated Benefit Open Enrollment meetings, processed and updated all employee changes according to Healthcare Reform
• Played active part in annual negotiations with providers
• Call Center -Benefits Administrator Benefits Administrator for over 15,000 lives in call center environment
• Maintain strong organizational skills in a high volume fast paced atmosphere
• On-Boarding for all new hires for clients with over 5000 employees
• Complete and process all STD, LTD, Life and EOI applications
• Maintained weekly report for STD, LTD, and Life claims. Review and update all approved claims through ADP benefits systems.
• Addressed all pending applications for STD, LTD and Life Claims to assure all necessary information was obtained for completion.
• Followed up on all employee dependent verifications to assure coverage
• Established positive relationships with multiple Carriers to address enrollments, claims, billing, tier changes,
• Coordinated all claim reconciliations by acting as liaison between doctors' offices, medical facilities, employees and carriers to assure timely payment of claims
Supporter of the American Breast Cancer Society and St Jude Children's Hospital ;
Enjoy Cooking for family and Friends.; Avid Food Network and HGTV fan;
Enjoy living a healthy lifestyle; Love my golden-doodle, an advocate of Animal Adoptions
Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.
Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:
Job Titles Held: