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Skills

  • Insurance policy underwriting
  • Contract negotiation with large providers
  • Organization
  • Relationship development
  • Corporate Client Retention
  • Process improvement
  • Insurance compliance training
  • Health insurance software proficiency
  • Claims processing optimization
  • Budgets

Work Experiences

  • Advised clients on the integration of telehealth services into their health plans, resulting in 62% increased utilization with zero increases in premiums.
  • Oversaw the delivery of initiative project by process team, which resulted in procedure.
  • Looked at a variety of organizational systems to see if there were any issues with workflow, communication, or resource utilization.
  • Worked with business leaders in the areas of cross-functional collaboration, data analysis, and project management.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Analyzed risk for health insurance plans.
  • Achieved results during year-end periods.
  • Achieved sales growth within 2015.
  • Achieved successful resolution in 21% of cases.
  • Achieved a customer satisfaction rate of 23%.

Summaries

  • Achieved optimal health coverage for clients.
  • Health Insurance Consultant capable with a track record of improving Miscellaneous operations.
  • Adapted to legislative changes.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Conducted comprehensive trend analysis using Microsoft Excel.
  • Achieved 79% reduction in annual employee costs.
  • Assisted clients with appeals.
  • Achieved a 23% reduction in processing times.
  • Achieved 28% new business within 2015.
  • Achieved significant client savings.

Accomplishments

  • Guided 7 clients through claims appeals processes, resulting in successful resolution in 81% of cases by providing tailored guidance and accurate documentation.
  • Trained 9 healthcare administrators on insurance billing practices, reducing claim rejection rates by 40%.
  • Resolved product issue through consumer testing.
  • Analyzed health plan data for initiative, which contributed to a 51% increase in client portfolio profitability.
  • Proposed new policy frameworks for high-risk candidates, reducing annual out-of-pocket healthcare expenses by $4.
  • Improved client engagement matrix by setting up a proactive communication platform, resulting in a 56% improvement in customer service feedback.
  • Conducted compliance audits for health insurance claims, ensuring 15% adherence to federal and state regulations.
  • Acted as a liaison between the actuarial team and sales division, enabling precise risk analysis, leading to optimal pricing for 18 insurance products.
  • Enhanced onboarding and training processes for 13 team members, leading to improved time-to-productivity by 62%.
  • Introduced value-added services to premium plans, resulting in a 64% increase in upsell rates.

Affiliations

  • Project Management Institute
  • Affiliation with the Health Information Management Systems Society (HIMSS)
  • Society of Human Resource Management
  • American Academy of Professional Coders (AAPC)
  • Active participant in National Committee for Quality Assurance (NCQA)
  • Member, Society of Actuaries procedure
  • Board Member, Health Insurance Forum program
  • Certified Health Insurance Specialist (CHS) Designation from method
  • Professional Member, Association for Healthcare Risk Management of America (AHRMA)
  • Association for Computing Machinery

Certifications

  • Insurance Industry Essentials – Lakeside Partners
  • SHRM Certified Professional (SHRM-CP)
  • Associate, Health Insurance Compliance (AHIC)
  • CompTIA Network+
  • CMS Medicare & Medicaid Compliance Certification
  • Certified Management Consultant (CMC) – Healthcare Specialization
  • ACA Health Insurance Certification
  • Salesforce
  • Certified Public Accountant
  • CompTIA A+ Technician

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