Experience

The Arc Central Chesapeake Region

• United States
• Non-profit Organizations
• 1 - 100 Employee

• FMS Enrollment Coordinator

  • Aug 2021 - Present



Private Client

• Delivering in home nursing assistant care to private clients

  • Jun 2018 - Present



Howard Community College

• United States
• Higher Education
• 700 & Above Employee

• Attended nursing school

  • Aug 2017 - Sep 2019



CareFirst BlueCross BlueShield

• United States
• Insurance
• 700 & Above Employee

• Contract Analyst

  • Apr 2003 - Aug 2017

  Serve as team lead for Contract Technicians in self-insured contract completion, providing training and subject matter expertise in new processes, systems, and forms, as well as contract interpretation, answering contract-related questions, providing support in medical terminology, non-standard wording. Report to Supervisor, Contracts & Booklets. - Accountable for review, analysis, development, and evaluation of the company’s most complex contracts for 13 high-profile private and government… Show more Serve as team lead for Contract Technicians in self-insured contract completion, providing training and subject matter expertise in new processes, systems, and forms, as well as contract interpretation, answering contract-related questions, providing support in medical terminology, non-standard wording. Report to Supervisor, Contracts & Booklets. - Accountable for review, analysis, development, and evaluation of the company’s most complex contracts for 13 high-profile private and government accounts. Manage a diversity of special projects. - Ensure accurate integration of ongoing state medical care mandates and the Affordable Care Act (ACA) regulations into health insurance contracts. - Rapidly learned and assumed additional accountability for contracts from the Washington D.C. office, including administrative services agreement language. - Collaborate extensively with Sales, Legal/Contracting and Compliance, and Audit groups in timely quality execution of work. Represent the department in organizational meetings. - Serve as SharePoint Administrator for department. Utilize proprietary mainframe applications and databases. Produce and distribute weekly activity reports using MS Excel, MS Word, and MS Outlook. - Attained key performance metrics: timelines, individual accountabilities, project management, team support, production, and quality interpretation.

• Contract Specialist (Contracting & Compliance)

  • Aug 2002 - Apr 2003

  Developed group account specific contract, benefit guide and certificate language for risk and non-risk accounts for 8 products using 40+ established models and templates; reviewed, clarified and/or interpreted customized (nonstandard) benefit requests. - Key contributor to Sales Operations meetings and processes to approve proposed benefits. Clarified and ensured consistency of contract benefits with respective system benefit coders. - Audited risk and non-risk contracts (fully-insured… Show more Developed group account specific contract, benefit guide and certificate language for risk and non-risk accounts for 8 products using 40+ established models and templates; reviewed, clarified and/or interpreted customized (nonstandard) benefit requests. - Key contributor to Sales Operations meetings and processes to approve proposed benefits. Clarified and ensured consistency of contract benefits with respective system benefit coders. - Audited risk and non-risk contracts (fully-insured / self-insured), benefit guides and certificates and other promotional materials to ensure accuracy with MIA approved forms; resolved issues with Sales/Marketing, Underwriting, Auditors, Service and Claims Training, Appeals Management and Analysis and Membership Departments. - Reviewed, interpreted, and responded to account-specific RFIs and RFPs and other standard and nonstandard requests; and interpreted benefit issues; provided contract interpretation, information and language. - Ensured high levels of customer satisfaction and legal compliance, achieved by ensuring contracts, health insurance benefit guides, certificates and other forms were accurate and complete.

• Contract Technician III (Major National Accounts)

  • Mar 2000 - Aug 2002

  Promoted to manage 39 major national accounts. - Created complex account-specific benefit contracts and maintained account information in compliance with Maryland Insurance Administration approved forms and state and federal laws and regulations. - Collaborated with Contracting and Compliance to ensure contracts and guides complied with Maryland Insurance Administration approved forms and state and federal laws and regulations. - Performed complex new account implementation on the… Show more Promoted to manage 39 major national accounts. - Created complex account-specific benefit contracts and maintained account information in compliance with Maryland Insurance Administration approved forms and state and federal laws and regulations. - Collaborated with Contracting and Compliance to ensure contracts and guides complied with Maryland Insurance Administration approved forms and state and federal laws and regulations. - Performed complex new account implementation on the company’s mainframe applications.

• Contract Technician (51+ accounts / Indemnity)

  • Apr 1998 - Mar 2000

  Promoted to create and administer account-specific benefit contracts and subscriber benefit guides utilizing master documents. - Analyzed and researched benefit information; shared benefits interpretation with internal clients. - Participated in account implementation committee meetings.

• Contract Technician (HMO)

  • Nov 1992 - Apr 1998

  Created and maintained account-specific contracts for 6 HMO subsidiaries, utilizing master documents. - Drafted HMO contract form filings as assigned by Supervisor/Contracts Administrator. - Provided new hire training as needed.