Self-directed leader with over 15 years of experience in insurance and underwriting. Strong collaborator with a successful history of improving underwriting policies to meet dynamic company, customer and industry requirements.
Overview
20
20
years of professional experience
Work History
Senior Underwriter
Blue Cross Blue Shield of Tennessee
06.2024 - Current
Mentored junior underwriters, fostering their professional growth and enhancing team performance.
Applied knowledge of underwriting guidelines to maintain compliance with applicable regulations and company standards.
Streamlined underwriting processes for increased efficiency and faster turnaround times.
Reduced claim losses by applying expert knowledge in identifying potential risks and setting appropriate premiums.
Rated groups with over 100 employees using fully insured, self funded, level funded rating.
Senior Underwriting Consultant – Large Group
Aetna
10.2021 - 05.2024
Communicates and partners with sales representatives, account managers, brokers, customers and prospective customers regarding case issues, underwriting assessments, pricing and rating with a customer focus.
Calculates renewal and new business rates for large complex cases based on thorough analysis of experience, location, demographics, etc.
Participates in major multi-functional teams as underwriting representative.
Surveys existing product portfolios by market, monitors sales results, trends and needs, recommends product portfolio changes.
Independently handles complex inquiries in their interaction with other functional areas of underwriting.
Successfully calculates rates for new business and renewals groups with 100+ members, on fully Insured, and self-funded accounts.
Mentors and trains less experienced underwriters
Builds and maintains training modules.
Act as a backup and subject matter expert to management.
Remote
Senior Underwriting Consultant - AFA
Aetna
06.2018 - 10.2021
May assist manager with team projects by providing information and collecting data.
Under general supervision, makes recommendations for plan changes and rate impact based on financial analysis, underwriting principals, and AFA business strategy.
Applies underwriting guidelines in qualifying risk of groups of 2 - 100 members.
Provides underwriting support for new business, sold and renewals.
Mentors and train less experienced underwriters.
Utilizes rating/financial tools, reference materials, prior carriers data and source systems for premium, membership and claim information
Maintains and develops training for department underwriters.
Senior Group Underwriter
Anthem Blue Cross Blue Shield of GA
07.2009 - 06.2018
Compute and establish renewal rates for groups with various financial arrangements.
Compute Specific Stop Loss and Aggregate rates for ASO, MPA and level funded.
Evaluate risk, define benefits for new and renewal large group business.
Meet with external Broker/Consultants as needed Prepare ad-hoc reports for upper-level management decision making.
Group Underwriter
Wellpoint Blue Cross Blue Shield of GA
10.2005 - 07.2009
II – (Small Group) Evaluate risk for new and renewal small group business (2 -99 cts) Compute and establish renewal rates for groups on a monthly basis.
Verify benefits and renewal rates for accuracy in the renewal rating system.
Review and approve special requests involving claim and membership eligibility issues.
Review requests for processing of change notices involving plan and benefit changes.
Prepare ad-hoc reports for management decision making.
Education
Bachelor of Science - Management
Shorter University
Rome, GA
Skills
Strong attention to detail
Good knowledge of Window’s based software (Word, Excel)
Ability to accept personal responsibility and ownership of issues
Knowledge of Group Benefits contract provisions and administrative practices
Understanding of Group Health, Dental and vision insurance concepts and product offerings
Strong mathematical aptitude
Ability to effectively engage, negotiate and communicate with internal and external partners
Attention to Detail
Independent, self-motivated individual with ability to manage multiple tasks and deadlines simultaneously
Customer Focused: Passionate drive to delight our customers and offer unique solutions that deliver on their expectations
Business System Analyst at Blue Cross Blue Cross Blue Shield of Tennessee (Facets Billing)Business System Analyst at Blue Cross Blue Cross Blue Shield of Tennessee (Facets Billing)
CERTIFIED COMMUNITY BEHAVIORAL HEALTHCARE CLINIC CLINICIAN at PINE BELT MENTAL HEALTHCARE RESOURCESCERTIFIED COMMUNITY BEHAVIORAL HEALTHCARE CLINIC CLINICIAN at PINE BELT MENTAL HEALTHCARE RESOURCES