Summary

Dear Hiring Manager:

• As a seasoned and effective professional, I believe my experience and demonstrated commitment t excellence render me the ideal candidate for the role .
• With a stellar track record of successful product launches and marketing initiatives, it is a pleasure t submit my resume for your consideration. I believe that upon review, you will recognize that my skill set is in line with what the role needs. My strengths match those most essential for consistent growth and
• Effective at executing strategic initiatives that increase productivity and reduce cost
• Highly skilled in assessing problem situations and providing effective solutions
• Motivated, enthusiastic and thrives on challenges and opportunities t stimulate

Positive change

• As you will see, I have had extensive work experience as a Sr. Analyst, Project Manager, Customer Service Representative, and Union Representative, giving me varied skills and the ability t work with many different types of people. I believe I could easily fit int your team.
• My dedication, coupled with a tactical approach t process improvement, will continue t enable me t have a positive impact on the company's bottom line. I am confident my combination of drive and experience will provide you with an invaluable resource.
• I am excited about the possibility t join your team.
• Thank you for your time and consideration.
• CAREER Summary: Action oriented, and result focused professional offering experience with the last few months focused on Small Group Sales Strategy at Blue Cross Blue Shield of Michigan. Skills in Project Management and problem solving have attributed t successful execution of several Middle and Small Group initiatives.

PROFESSIONAL EXPERIENCE:

Senior Sales Analyst

Confidential

• Research Competitors agent commission for small and middle groups, research the development of Blue eSolutions, attend training sessions with agents and managing agents as a subject matter expert for Blue eSolutions, research Affordable Care Act ACA issues for middle and small groups, work with cross functional teams t ensure BCBSM compliance with coverage, participated with various work groups involved with 2014 HealthCare Reform initiatives.
• Analysis Testing of Blue eSolutions, analyze the business readiness and rollout t our external customers, review and create reports that analyze BCBSM/BCN agent compensation in the middle and small group segment, analyze the testing of the Agent Toolkit, work with our legal department regarding ACA, review DIFS Department of Insurance policies and regulations as it pertains t small and middle groups.
• Senior Sales Analyst
• Maintain a relationship with our Consumer Driven Healthcare Vendors
• Complete Request for Proposals/Information RFP/RFI
• Consumer Driven Health Group Implementations
• Document Creation for MOS Migrated Groups
• System Testing UAT, Parallel and Benefit Testing
• BCBSA Policy Coordination
• Reporting SharePoint Maintenance, create unique reports for internal evaluation, Adhoc reports, Excel, Power Point Presentations, and proficient in Word presentations.
• Lead of project team
• Evaluate Projects

Confidential

• Research -Reviewed, analyzed and completed Request for Proposal documents for Consumer Driven Health CDH benefits, Develop benefit comparisons, coordinate the development and implementation of program specifications t develop contract language, researched benefit information in order t create and edit Benefit-At- A- Glance BAAGs , familiar with Group Sales processes for enrollment including functions performed in various areas such as Underwriting, Actuary, Group Administration, Corporate Database, MDSS, etc., researched issues for our CDH vendors and presented solutions.
• Analyze- Analyzed and interpreted benefit information for internal and external stakeholders, analyzed certificates, riders, and plan modification designs including form numbers and benefit impacts t draft benefit information summaries for groups, understand and applied Michigan Operating System MOS benefits structure including group division/BPID, reviewed State/federal mandates, including Health Care Reform, and Mental Health Parity and its impacts t benefits, translated the impacts t our internal and external customer, contributed t claims process improvement with CDH vendors WageWorks and HealthEquity.
• Project Lead
• Reporting Advanced experience of using Online Benefit Information OBI , ability t navigate in SharePoint using common features t add/delete/move files, understanding of BCBSM Web portals and technology.

Senior Analyst

Confidential

• Research Budget issues, identified business issues, researched standard policies and procedures, assured that corporate compliance was communicated t staff, researched State Mandates and analyzed the impact t BCBSM.
• Analyze Business problems and devised procedures for solutions t the issues, developed and improved work flows, decrease operational cost, effectively led projects in order t produce desired results, participated in system testing, assisted personnel internal and external by answering questions, supplying information and training, developed and maintained an effective working relationship with internal and external customers.
• Implemented Projects
• Project Lead
• Reporting Proficient in excel and Word.
• Work Driver Alert Team WDAT
• Policy Coordination based on Association and Corporate guidelines
• Represented the Director at local and divisional meetings.
• Reviewed and assisted in maintaining the yearly divisional budget
• Participation in Resource Allocation Committee RAC
• Created, reviewed, and maintained divisional Standard Business Proposals and Business Cases
• Communicated with Directors nationally regarding various BCBSM policies and procedures

Account Service Representative

Confidential

• Created Benefit-at-a-Glance BAAG summaries for internal and external customer groups
• Identified and reported account issues and competitive activity
• Prepared proposal requests, calculated rates, and generated new group enrollment kits and coverage upgrade kits
• Assisted in and coordinated reopening process with Marketing staff t secure required information
• Maintained and updated enrolled/prospective account records
• Performed process analysis t increase operational efficiencies and aid in the timely resolution of customer inquiries
• Developed and maintained an effective working relationship with customers and partners
• Represented department on cross-functional workgroups for new group implementations, new segment implementations and special projects such as Benefit File Automation and the Group Admin/Database Load Continuous Improvement Workshop
• Accompanied Account Manager on monthly client visits
• Handled all new group/group wide change activities and servicing issues including NASCO, Local, POS, and BCN
• Requested ad hoc reports for Account Managers, Accounts and Agents/Consultants pertaining t membership and claims issues in support of initiating recoveries or special account mailing or membership reporting, etc.
• Responsible for training new Account Service Representatives ASRs
• Worked on Benefit File Manager, including client-specific administrative criteria and benefit programs
• Created group applications, benefit summaries and comparisons, and administrative pages for each client
• SMART - update, monitor and oversee open issues and initiate follow up accordingly
• HCB and Member Self Service web capabilities

Customer Service Representative

Confidential

• Chrysler Service Center
• BCBSM Walk-in Service Center
• Local Group Service Center
• Federal Employee Program
• General Motor Service Center
• Phone/Written Representative for:
• National Customer Service Center Interpreting benefit and claim information for 67 groups
• Handling complex written inquiries, calculating deductibles/coinsurance, and pricing claims for 19 groups
• Providing resolution via telephone, ALGS/Self composed letter
• Participant in Cross Functional team that greatly increased interdepartmental
• coordination, providing a timely and efficient response t the customers
• Assisted Unit Leader and CSRIII with training New Hires
• Handled irate calls that may have jeopardized the maintenance of a group, subscriber, or provider
• Conducted internal and external research t provide accurate benefit/eligibility information
• Assisted Direct Billing reducing the call volume, providing customers with non-group and supplemental benefits, rates, billing and claims resolution
• Created departmental job aids and alerts for less experienced reps
• Pre-priced claims before sending them t the Pricing Department
• IRIS Workgroup- analyzed, organized, and prioritized customer service representatives CSRs complaints and devised a plan t improve the IRIS program
• Certified in Health Insurance Portability and Accountability Act HIPAA Compliance

Labor Relations-Union Steward for Local

Confidential

• Coaching and Development
• Grievance Handling
• Interest Based Problem Solving
• Facilitated Classes Working Effectively Together
• Co-Facilitated ABC's of the Blues
• Certified in Leader t Leader Experience
• Certified in Excellence in Leadership
• Completed People Skills Course.
• Completed Assertive Effective Communication
• Certified in HIPAA Compliance
• Addressed employee and HR concerns regarding company rules and policies t ensure that the rules didn't infringe upon employees rights