Dedicated Insurance/Benefits Analyst eager to contribute significant administrative, client relations, consulting, and account servicing expertise toward supporting a dynamic employer in optimizing bottom-line performance.
Substantial abilities in assessing coverage eligibility, conducting market/trend analysis, researching and resolving eligibility issues, instituting process improvements, and streamlining benefit programs to meet specific client needs.
Outstanding blend of project management and team leadership expertise.
Excel in analyzing client requirements, maintaining existing systems, coordinating projects, creating and implementing testing plans, and generating reports.
Methodical problem solver with a solid track record of executing innovative and strategic solutions to meet defined business goals and needs.
Offer a sharp blend of interpersonal, critical thinking, customer relations, and analytical skills.
Extremely versatile with an exemplary ability to quickly master new roles, environments, tasks, software, and responsibilities.
Aliquant Corporation, Pittsburgh, PA, 2007 to Present
Efficiently and accurately provide third party benefit administration support encompassing enrollment/eligibility, coverage inquiries, payroll deductions, trend analysis, client billing and premiums.
Administered annual enrollment and literature distribution in alignment with region, plan details, and COBRA requirements.
Participate in employee with dependents annual recertification project with a focus on verifying benefit coverage eligibility through web-based processes.
Partner with internal programmers to troubleshoot, test, modify and optimize online eligibility program.
Demonstrated impressive initiative in preparing precise instructions for Human Resource departments on how to update employee data/benefit information, view benefit offerings and initiate enrollment events in HRIS.
Yyyyyy x. yyyyyy Consulting, Pittsburgh, PA, 2002 to 2008
- Applied superior knowledge of group insurance toward preparing proposals for small and medium sized clients, recommending appropriate plan design, and implementing enrollment procedures.
- Innovatively assembled a new hire employee packet to validate social security, employee salary, I9/W4, driver s license and benefit data, and eliminate submission errors to government agencies.
- Created a comprehensive policies and procedures manual for an accounting business, successfully covering payroll processes, insurance requirements, filing protocols, human resource administration and client contact management.
- Leveraged excellent technical acumen to implement HRIS for employers to manage staff benefits and generate reports using Excel and Access.
- Fostered, nurtured and maintained strong client relationships to maximize loyalty and referral business.
Yyyyyy x. yyyyyy ~ Page 2 of 2
Professional Experience continued
UPMC Health Plan, Pittsburgh, PA, 1998 to 2002
Steadily advanced through a series of promotions based on proven dedication, performance, and results.
Completed training in AMISYS and participated in system conversion, upgrades and testing.
Proactively explored and formulated new health plan product designs and assisted with launching new competitive PPO plan vital to maximizing member interest and market share.
Created Welcome Kit packages for new medical benefit members and collaboratively designed internal audit system to ensure correct information packet distribution.
Expeditiously submitted all commercial insurance forms/documents to Pennsylvania Insurance Department.
Demonstrated a solid team player work ethic as Chairperson for New Benefit Approval/Reimbursement Committee and as New Employee Trainer for sales/marketing and customer service personnel.
Partnered with Actuary Department on Preferred Provider plan benefit to ensure competitive positioning.
- Directed, coached and led team in identifying and eliminating loophole language and updating existing documents to bring clarity to benefits, exclusions, limits and definitions.
- Tested and maintained all Commercial, Medicare and Medical Assistance insurance benefit plans in the system.
Team Leader, Member/Provider Services
- Chosen to direct operations for start-up call center/customer service facility and provided consummate leadership and supervision to staff including issue escalation.
- Expertly responded to 80+ inquiries daily related to eligibility, coverage issues, claims and premiums from employers, brokers, plan members and healthcare providers.
- Updated insurance benefit plan documents for over 200 groups, exhibiting first-rate organizational strengths.
HealthAmerica, Pittsburgh, PA, 1994 to 1998
LPN / Customer Service Associate
- Merged strong communication and interpersonal skills to effectively respond to an average of 75 calls daily from members inquiring about eligibility, coverage and claims.
- Processed medical and dental claims and provided support to plan members during Grievance hearings.
Microsoft Office Suite (Word, Excel, Access, Outlook, PowerPoint, Project), Benesoft, PeopleSoft, SAP
BS in Business Administration and Accounting, State University of New York, Brockport, NY
Hiring Agent Name
I am currently seeking a challenging career opportunity in a <insert job title/position> capacity and am submitting my resume for your review. In advance, thank you for your time and consideration.
I bring to you proven performance in insurance benefits analysis and administration, exemplary expertise in project and team leadership, and strong skills in system analysis, process standardization, and implementing measurable process improvements. To complement these qualifications, I offer outstanding prioritization talents and solid organizational capabilities which are instrumental in a <insert job title/position> role.
As a proactive contributor to your organization, you will find me to be a self-motivated professional committed to supporting you in achieving your objectives through superior initiative, unparalleled resourcefulness, and extensive analytical proficiencies. I am confident that I could be a valuable asset to <insert name of company>, and look forward to interviewing with you in the near future.
Yyyyyy x. yyyyyy
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