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yyyyyy x. yyyyyy

 

job title:                      program specialist, gs-0301-09/13

job announcement:     hhs-os-2010-0112
agency:                        office of the secretary of health and human services

sub agency:                department of health and human services


core competencies

 

program development, program administration, reviews/evaluations, research/analysis, project management, contract management, regulatory compliance, quality assurance, reporting, auditing, information systems management, human resources, staffing, training, supervision, workflow planning/distribution, cost controls, administrative operations, executive support, customer service, account management,  communications, consulting, advising, negotiations, presentations, interpersonal relations,  insurance claims, investigation, invoicing, payment processing

 

professional experience

 

1999 - present

claims specialist

specialty risk service

shawnee mission, ks/lake mary, fl

hours per week: 40

annual salary: $50k

supervisor: amy devine-murphy; phone:xxx-xxx-xxxx; contact: yes                 

consistently ensure delivery of exceptional customer service in facilitating claims processes.  actively negotiate and authorize settlement of claims for large third party administrator (tpa) accounts throughout fl, ga, al, tn & ky; previously managed ks, mo, ia and ne region, 1999-2006.  proficiently prepare and present quarterly claim reviews for all clients.

conduct thorough research, analysis and review of claims for quality control and compliance.  efficiently monitor contract specifications and confirm services are delivered in accordance with established contractual guidelines. cost-effectively retain independent defense attorneys and nurse case managers.

 

1998 - 1999

customer service representative

haas & wilkerson

shawnee mission, ks

hours per week: 40

annual salary: $35k

supervisor: bill wilkerson; phone: 913-432-4400; contact: yes               

supported broad-scope operations of busy insurance company through dynamic administrative support of senior management, with consistent focus on optimizing client servicing and relations. productively coordinated and processed high volume of large commercial general business accounts of company chief executive officer.   provided quality summarizations of insurance details. efficiently invoiced and reviewed bound policy, including audits and endorsements.

 

1997 - 1998

senior claims representative 

lockton companies

prairie village, ks

hours per week: 40

annual salary: $32k

supervisor: marianne peterson; phone: 816-960-9000; contact: yes       

           

page 1 of 3

celeste k. maulfair                                                                                 page 2 of 3

lockton companies continued

 

spearheaded claims resolution of assigned accounts and proactively liaised between client and insurance carrier to maximize outcomes.  contributed subject matter expertise by participating in claim meetings, tpa negotiations, tpa audits, and quarterly claim reviews.

 

1996 - 1997

senior claims representative

thomas mcgee, l.c.

kansas city, mo

hours per week: 40

annual salary: $27k

supervisor: bill fuss; phone: 816-842-4800; contact: yes

facilitated timely handling of medical only and minimum lost time claims for tpa accounts as well as processing of payments to claimants and providers.

 

1988 -1996 (various positions concurrent with raising children)

 

office administration, pro staff personnel services-kansas city, mo; hours per week: 27; annual salary: varied; supervisor: n/a; company phone: 816-505-3020; contact: yes

substitute supervisor, park hill school district-kansas city, mo; hours per week: 20; annual salary: varied; supervisor: mike otto; phone: 816-359-4340; contact: yes

teacher/teacher aide, first baptist church-blue springs, mo; hours per week: 20; annual salary: varied

supervisor: n/a; church phone: 816-229-8522; contact: yes

                     

 

1984 - 1987

claims specialist

employers reinsurance corporation

shawnee mission, ks

hours per week: 40

annual salary: $28k

supervisor: bill fagerberg; phone: 913-676-5200; contact: yes
demonstrated strong prioritization, workflow planning and project management skills in effectively supervising daily average of 600+ insurant agent professional liability claims covering a 13-state territory; expertly determined coverage and evaluated agent liability as well as negotiated and authorized settlements. strategically retained independent adjusters and attorneys to maximize discover and defense performance as well as cost controls.  collaborated with attorneys in conducting periodic file reviews.  boosted operational efficiencies by resourcefully creating and managing a departmental educational reference library.

 

1981 - 1984

outside commercial casualty claim representative

aetna casualty and surety

kansas city, mo

hours per week: 40

annual salary: $24k

supervisor: n/a c company out of business

optimized customer relations by productively interfacing with claimants, attorneys and varied stakeholders in settling claims as well as providing analytical review and detailed documentation. conducted thorough investigations and evaluations of claims spanning liability (personal, product, medical practice), bond, workers compensation, and property.  held authority for negotiating, authorizing and paying settlements. 

successfully retained independent defense attorneys to support objectives of ensuring effective discovery and cost management.

contributed sharp management skills and business acumen toward collaborative department supervision as well as claim and caseload assignment and file review.  actively assisted in orienting and training personnel to support optimal productivity and quality of work as well as compliance with company policies and procedures.

 

celeste k. maulfair                                                                                 page 3 of 3

aetna casualty and surety continued

 

1979-1981

assistant store manager

county seat

shawnee mission, ks

hours per week: 40

annual salary: $10k

supervisor: georgia taylor; phone: n/a; contact: yes

drove full-scope store operations, from staffing, scheduling, team supervision, sales, and customer service to maintenance, inventory control and merchandising; entrusted with serving as acting store manager.  held personal responsibility for overseeing maintenance staff.  designed and implemented an enhanced inventory control program; reduced static inventory by 80%.  led store to increase sales by 15% through innovative displays and merchandising strategies.   

 

1978-1980

zone management trainee/sales clerk

sears roebuck & company

shawnee mission/manhattan, ks

hours per week: 40

annual salary: $9k

supervisor: n/a; company phone: 913-967-8799 and 785-532-0232; contact: yes

capitalized on opportunity to participate in company management training program.

 

education

 

kansas state university

manhattan, ks

degree: bs in fashion marketing

date earned:

gpa: 2.8

credit hours: 130

 

specialized training/certifications

 

aei c legal principals designation
cic - commercial property, casualty, agency, personal lines
hartford intermediate work comp school

chartered property casualty underwriter (cpcu) 1 & 2

 

technical skills

 

insurance software: csonline, delphi, applied  

ms applications: microsoft word, excel, powerpoint

 

community leadership

 

founding board member of child care program, including development of bylaws and guidelines

treasurer pta

media center volunteer coordinator, pta

 

 

 

 

 

 

 

 

 

 

yyyyyy x. yyyyyy

 

job title:                      program specialist, gs-0301-09/13

job announcement:     hhs-os-2010-0112
agency:                        office of the secretary of health and human services

sub agency:                department of health and human services

 

 

 

date

 

 

 

office of the secretary of health and human services

department of health and human services

 

re:      job announcement# hhs-os-2010-0112

           

 

i would like to thank you for providing me the opportunity to interview with you and discuss the exciting program specialist position available with your agency.  having gained a deeper insight into the job requirements and your objectives, i am confident you will find me a valuable asset in achieving your goals.

 

as discussed, i am a performance-driven  team player with the skills and knowledge required to effectively support this position.  in particular, i believe my dynamic (list a few skills/qualifications relevant to the position that you discussed during the interview) skills will be key factors to excelling in supporting your operations, and i am positioned to deliver both immediate and long-term results as a member of your staff.

 

should you have any additional questions, or to further discuss this opportunity, please feel free to contact me at your earliest convenience.  again, thank you for the enlightening interview.  i look forward to your response.

 

sincerely,

 

 

 

celeste k. maulfair

 

 

 

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