Benefits Account Manager

• Nov 2015 - Present

Sales Coordinator

• Aug 2014 - Nov 2015

IFP and SB Sales RFPs, account management, underwriting, open enrollment Account Services - broker appointments, billing, eligibility Business Development IFP and SB Sales RFPs, account management, underwriting, open enrollment Account Services - broker appointments, billing, eligibility Business Development

Provider Relations Specialist

• Jul 2013 - Jan 2014

• Liaison between the provider community and the health plan requiring 90% travel • Performed provider orientations for the rural counties transitioning from fee-for-service to Managed Care Medi-Cal • Educated providers regarding policies and procedures related to referrals, claims submission, and pre-authorizations • Facilitated web site education, promoted EDI, subsidiary companies, vendors and specialty programs • Conducted at least 60 monthly face-to-face meetings with the contracted providers documenting discussions, issues, attendees, and action items • Researched claims issues to identify adjudication errors, and educated providers on billing trends • Received and responded to external provider related issues as primary contact and internal work queues assigned • Initiated demographic, and contract changes by relaying to the appropriate departments • Encouraged credentialing of new providers and collected missing information

Provider Relations Representative

• Jan 2011 - Oct 2012

• Recruited optometrist and ophthalmologist • Claims resolution • Provider training • Resolved member grievances • Built claims records based on affiliations and private practices • Provided input on the provider office manual and website user interface • Pulled license verifications, NPIs, and identified missing documentation for the credentialing team • Sustained large territory assigned • Recruited optometrist and ophthalmologist • Claims resolution • Provider training • Resolved member grievances • Built claims records based on affiliations and private practices • Provided input on the provider office manual and website user interface • Pulled license verifications, NPIs, and identified missing documentation for the credentialing team • Sustained large territory assigned

COBRA Account Manager

• Sep 2009 - Dec 2010

• New business implementation – client service agreements, benefit summaries, rates, entered participant information, client service presentation, communication with the insured • Open enrollment – entered rates and benefits, mailed verification with open enrollment packets • Determined carrier eligibility by reviewing invoices and member data • Reviewed deposits and withdrawals, Provided strategic ideas for transition to another Wells Fargo COBRA Administrator made payment adjustments, confirmed rates and lines of coverage • Processed initial notices, qualifying events, carrier applications and terminations • Serviced client by generating various reports, problem resolution, and educating the company representative

Sales Support

• Jan 2005 - May 2009

• Licensed in thirty two states; produced health, dental, vision, life, short-term and long-term insurance sales • Pre-qualified small businesses, determined underwriting requirements per carrier, state and/or federal laws • Marketing – proposed benefit package for type of industry, budget and group health care needs • File management • Corrected problematic online experience, audited website output • Provided sales support for Account Executives • Licensed in thirty two states; produced health, dental, vision, life, short-term and long-term insurance sales • Pre-qualified small businesses, determined underwriting requirements per carrier, state and/or federal laws • Marketing – proposed benefit package for type of industry, budget and group health care needs • File management • Corrected problematic online experience, audited website output • Provided sales support for Account Executives