Andreana Lewis
Dunbar,United States
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Account Executive
The Health Plan
Charleston, West Virginia
08.2023 - Current
- Responsible for the implementation of new and renewing clients.
- Execution of contracts with clients for the provision of elected plans.
- Design plan structures and/or presentations for prospective or current clients.
- Make determination of products offered to clients.
- Provide after-sales support to new and renewing clients.
- Illustrate the value of products and services to create growth opportunities; compile and analyze data to identity trends.
- Make recommendations regarding account/claims appeals.
- Revise, finalize and approve language in plan members Summary of Benefits and Coverage documents reflecting the benefits offered.
- Maintain frequent contact with the clients and/or agents to understand and address all needs.
- Build and maintain lasting relationships with brokers and/or clients.
- Facilitate meetings with benefit managers/brokers to better help under the clients needs.
- Prepare reports and analysis of performance for assigned clients.
- Stay current with company offerings and industry trends.
- Follow up with clients and/or brokers regularly to ensure needs are being met and identify new opportunities.
Eligibility Specialist
The Health Plan
Charleston, WV
08.2018 - 08.2023
- Enter eligibility information such as; new accounts, changes and terminations into WEX for the FSA, HRA and HSA accounts in an accurate and timely manner.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Maintained positive working relationship with fellow staff and management.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Answered questions and responded to inquiries from Brokers and HR Representatives about accounts.
- Prepare Excel reports regarding elections, demographics, debit cards and account balances.
- Assist the Account Executives with group set-up, enrollment and balance inquiries.
- Assist the Account Executives and Employers with the WEX employer portal.
- Assist IT with large eligibility uploads.
- Identify and assist with client eligibility issues.
- Assist IT with creating the monthly invoices for CDS groups.
- Mail or email out the monthly Admin invoices for the CDS groups.
- Audit accounts to ensure correct balances.
- Audit accounts to close zero balance accounts.
- Validate Identity Verification Failures with WEX and HealthCare Bank.
- Add Banking information to individual accounts in WEX.
- Work with Finance to ensure contribution posting, closing of accounts, and ACH set-up.
- Update addresses on returned mail per the group and reissue returned mail.
- Responded to client inquiries and concerns in regard to account set-up or enrollments.
- Participate in WEX update release trainings.
- Prepared reports on enrollment statistics and discussed how to improve enrollment procedures during team meetings.
- Explained account setup to employers, answering questions or concerns.
Claims Processor
The Health Plan
Charleston, WV
02.2015 - 08.2018
- Verified claim data correctness in preparation for processing of reimbursement/payments.
- Processed claims (HRA, FSA, DFSA, Transit) according to established quality and production standards and made corrections and adjustments to solve problems.
- Report patterns of incorrect billing and utilization to the manager.
- Addressed customer inquiries to provide information and explanations on coverage and terms, expediting claims with a quick and accurate response.
- Responsible for answering inbound calls in a prompt courteous manner.
- Built rapport and trust with customers through effective customer service techniques which involved fair and prompt processing of claims.
- Process account refunds when received.
- Run balance reports in Excel to verify totals for weekly check processing.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
Education
Some College (No Degree) - Accounting And Business Administration
West Virginia State University
Institute, WVSome College (No Degree) - Business Administration And Management
Strayer University
Washington, DCSkills
- Payments Posting
- Claims Review
- Medical Terminology
- Verbal and Written Communication
- Eligibility Determination
- Data Entry
- Microsoft Office
- 10-key Touch
- Account Renewals
- Account oversight
- Relationship building and management
- Managing client relationships
Accomplishments
- Maintained an "exceeds requirements" on all performance plans with The Health Plan.
Affiliations
- The Society for Collegiate Leadership & Achievement (SCLA)
- Honors Program at Strayer University
Certification
- West Virginia Health Insurance License obtained February 2024
- West Virginia Life Insurance License obtained February 2024
References
References available upon request.
Timeline
Account Executive
The Health Plan
08.2023 - Current
Eligibility Specialist
The Health Plan
08.2018 - 08.2023
Claims Processor
The Health Plan
02.2015 - 08.2018
Some College (No Degree) - Accounting And Business Administration
West Virginia State University
Some College (No Degree) - Business Administration And Management
Strayer University
- West Virginia Health Insurance License obtained February 2024
- West Virginia Life Insurance License obtained February 2024
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