Experience

Arcosa Inc.

• United States
• Construction
• 700 & Above Employee

• Benefits Specialist

  • Jun 2023 - Present

  Dallas-Fort Worth Metroplex



Gallagher

• United States
• Insurance
• 700 & Above Employee

• Client Manager

  • Jun 2021 - Mar 2023

  Dallas, Texas, United States Job Purpose: The Small Group Account Manager is responsible for the day−to−day account management for small to mid−sized clients. • Communicate resources available within Gallagher to fill white space needs (Pharmacy Practice, Retirement, GGB, HR Consulting, Voluntary Benefits, etc.) • Manage accounts increasing in complexity and funding based on experience • Support the Client Service Cycle with oversight from experienced team members to ensure a seamless renewal process and… Show more Job Purpose: The Small Group Account Manager is responsible for the day−to−day account management for small to mid−sized clients. • Communicate resources available within Gallagher to fill white space needs (Pharmacy Practice, Retirement, GGB, HR Consulting, Voluntary Benefits, etc.) • Manage accounts increasing in complexity and funding based on experience • Support the Client Service Cycle with oversight from experienced team members to ensure a seamless renewal process and retain the business • Resolve service-related issues independently, involving more experienced Account Management team members when needed • Utilize Gallagher’s resources (Underwriting, Compliance), available tools (Excel, PowerPoint, • etc.), established work products and advanced knowledge (benefits, self-funding, etc.) to • maximize efficiency and effectiveness in client deliverables • Develop, cultivate, and maintain positive relationships within the branch, with clients and vendor partners • Maintain proficiency in all GBS standards • Prepare the RFP, coordinate vendor responses, support negotiations, analyze and spread • proposal results and develop the client presentation • Leverage team members to manage client/vendor expectations and ensure timely delivery of requests. • Possess ability to articulate account management role in client engagement • Provide guidance and support to new hires, and anyone that needs assistance • Maintain and prioritize a task list on a regular basis • Provide support to your Branch/Region by completing ad hoc administrative tasks as needed • Maintain up-to-date records in DMS • Comply with Gallagher’s process, BOSS standards and office initiatives • Complete training and professional development to gain understanding of the insurance industry and GBS processes. • Exemplify the highest ethical standards, promote ethical behavior, and uphold the Gallagher Way • Travel to onsite client meetings as requested/required by the client (approx. 20%-25% travel) Show less



Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma & Texas

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Small Group Account Manager (Small Group Client Rep)

  • Sep 2019 - Oct 2020

  Job Purpose: This position is responsible for ensuring continued and increased growth by renewing small group accounts or selling products and services to existing customers, understanding customer needs, and providing customer support in a call center environment. This position is responsible for researching and responding to telephone and written inquiries plus handling escalated issues in a prompt, accurate and objective manner. Accountable for meeting departmental small group accounts… Show more Job Purpose: This position is responsible for ensuring continued and increased growth by renewing small group accounts or selling products and services to existing customers, understanding customer needs, and providing customer support in a call center environment. This position is responsible for researching and responding to telephone and written inquiries plus handling escalated issues in a prompt, accurate and objective manner. Accountable for meeting departmental small group accounts retention goals and service goals. • Account Manager for renewing Small Group Accounts with 1-50 + members in the state of Texas with BCBS Medical and/or Dental health coverage. • Assist Small Group accounts with annual renewals and off cycle plan changes. Not limited to effective date changes, plan changes, rate changes, and group name changes. • Educate brokers/clients on alternate benefit solutions, as well as introducing client to more affordable plan options in order to retain business • Assist with setting up COBRA/TX State Continuation for employer groups. • Provides customer service support to the Insurance Broker, General Agents, Small Group and supporting business partners. Receive and respond to group or AOR/GA inquiries. Processed information from group or agent to determine needs/wants and ensure all request have been promptly and accurately addressed. • Resolve escalated issues to ensure client satisfactions; preventing exceeding retention goals. • Managing roughly 45-70 cases daily relating to Cancellations, Tier Reports, Renewals, Reinstatements, and Plan Changes. Completing the assigned cases quickly and accurately. • Maintain production requirements based on established department business needs. • Comply with PHI, SPI, HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. • Robust experience in written, verbal and interpersonal communication.

• Behavioral Health Coordinator- Appeals

  • Sep 2018 - Sep 2019

  Perform outreach to members and/or physicians as needed to provide assistance or schedule appointments. Responsible for documenting peer review outcomes in the medical management system. • Maintain production requirements based on established department business needs. • Provide support to the clinical team by performing the non-clinical functions necessary to generate and close a case within the platform. • Comply with HIPAA, Diversity Principles, Corporate Integrity… Show more Perform outreach to members and/or physicians as needed to provide assistance or schedule appointments. Responsible for documenting peer review outcomes in the medical management system. • Maintain production requirements based on established department business needs. • Provide support to the clinical team by performing the non-clinical functions necessary to generate and close a case within the platform. • Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. • Provide customer service support to the Behavioral Health Case Management, Utilization Management, Government Programs and Outpatient Services departments. Receive and respond to customer or physician inquiries. Process information from member or provider to determine needs/wants and ensure customer questions have been addressed. Respond to customer or send to appropriate internal party. • Research next level of appeal and communicate information to the member, provider, and facility when applicable. • Facilitate verbal and written communication of the initial peer review determination to the member, provider, and facility when applicable including any unable to reach communication. • Responsible for uploading clinical data to any external review organization to facilitate peer review completion within state and regulatory guidelines. • Knowledgeable in the areas of NCQA, URAC, and the guidelines with turn around times. • Generate or compose appropriate correspondence and send to members manually or electronically. • Facilitate scheduling clinical reviews with medical directors/physician advisors, including shaping request, initial peer reviews, post service reviews, appeals and other reviews requiring physician review.

• HR Service Representative (Employee Services I)

  • May 2017 - Sep 2018

  Job Purpose: Under supervision this position is responsible for providing timely and accurate service to customers (primarily active employees) by assisting in processing HR documents, i.e. benefit, salary, and status changes; providing information on a wide range of HR programs and services (via phone, chat, AskHR cases) and by the expeditious referral of more complex issues and sensitive inquiries to the appropriate area for resolution including, but not limited to, Benefits, Leaves of… Show more Job Purpose: Under supervision this position is responsible for providing timely and accurate service to customers (primarily active employees) by assisting in processing HR documents, i.e. benefit, salary, and status changes; providing information on a wide range of HR programs and services (via phone, chat, AskHR cases) and by the expeditious referral of more complex issues and sensitive inquiries to the appropriate area for resolution including, but not limited to, Benefits, Leaves of Absence, Payroll, HR Policy, Training, Work Life Programs, etc. Responsible for providing personable and accurate service to employees, in five states, confidentially. Which requires understanding and appreciation of the different views, expertise and experience of others; Assist in receiving and processing HR documents that affect salary such as pay changes, in-grade promotions, demotions, separation pay, bonuses, and wage garnishments. Processes employment, insurance and child support verifications for employees as requested and needed. Assist with annual benefit elections, such as Open Enrollment which included distributing benefit materials, processing elections, and addressing any benefit questions employees or retirees had regarding their elections. Works closely with Occupational Heath, to process Family Medical Leave request and returns. Assist with Onboarding New Hires, and obtained personal records which includes PHI, SPI and HIPPA information to import into HR systems. Works closely with Workforce Solutions as an intake specialist to assist with employee’s and or managers concerns relating to risk, job neglect, and even company safety issues confidentially. This requires one to understand the importance of judgments being based on factual information vs. assumptions. Discuss and explains paychecks and benefits deductions to employee’s in all salary ranges. Enlighten all employees, including Managers, Executives and Doctors on HR policies, and company policies.