Fonisha E Hardy

• Tier 2 Processing for Department Of Human services applications for the residents of Rhode Island for eligibility and correctness
• Process Redeterminations, Long Term Services and Support and Program Eligibility for participants
• Programs Processed for participants are: SNAP, Long term services and support and Medicaid insurance for the state of Rhode Island.
• Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
• Reviewed applications for different aid programs and determined which qualification criteria for individuals.
• Skilled at working independently and collaboratively in a team environment.
• Managed time efficiently in order to complete all tasks within deadlines.
• Passionate about learning and committed to continual improvement.

• Contact and qualify prospective customers and explain features and merits of Humana Medicare Advantage and Medicare Supplement policies offered, recommending amount and type of coverage based on analysis of prospect's circumstances
• Communicates professionally with customers to explain policies, show value of brand represented, follow-up as necessary to sell appropriate plans or policies
• Calculates and/or quotes premium rates for recommended policies
• Develops and maintains thorough product knowledge for the Humana client
• Demonstrates a high degree of integrity and follows compliance/quality assurance requirements
• Utilizes client and/or company-provided computer systems to perform accurate and timely data entry and submit applications
• Follows scripts and designated sales processes to complete sales in a compliant and effective manner.
• Developed and maintained comprehensive understanding of products, services and competitors to enhance sales presentations.
• Developed and implemented sales strategies to increase profits.
• Utilized CRM software to manage customer accounts and track performance metrics.
• Listened to customer needs and desires to identify and recommend optimal products.

● Evaluated new case and add-on risks, assuring timely and quality underwriting.

● Evaluated enrollment materials and detailed medical records to determine underwriting actions.

● Enrolled new groups and members on the carrier's online systems.

● Reviewed final rates, benefit options, and underwriting requirements.

● Generating quotes, based on actual enrollment, to ensure accurate premiums are being sent to insurance carriers.

● Notified agents/brokers of overdue premium payments and status of cases, whether the cases are approved, declined, or withdrawn.

● Processed brokers of record change letters and licensing for agents to assure new agents are correctly paid, carrier guidelines are followed, and agents/brokers are properly appointed with each carrier.

• Interacted with internal customers to understand business needs and translate into requirements and project scope.
• Applied honed problem-solving skills to analyze and resolve issues impacting business operations and goal achievement.

• Assist 50+ companies with their employees medical, dental, vision and supplemental benefits on the phone, online and via email
• Answered questions and administered benefits for employees in regards to New hire enrollments, Qualifying life events, Medicare and Open enrollment
• Responds timely to a high volume of employee inquiries, evaluates eligibility, and benefits coverage based on policies and regulatory guidelines to maintain accurate benefits related records and enrollments.
• Managed enrollment process for new hires, addressed ongoing demographic updates and coordinated annual deferred compensation plan process.
• Administered medical, dental and vision benefit plans and also handled flexible spending, health savings and health reimbursement accounts in compliance with federal and state regulations.
• Delivered exceptional customer service on benefits issues through active listening, patience and prompt response with resolutions or actionable next steps.

• Processed benefits enrollments and Life events for Builders First Source new hire employees and existing employees as well, over the phone or via Virtual chat and video.
• Administered and communicated benefits to over 30,000 for Builders’ first source and BMC employees at a corporate level over the phone.
• Responded to incoming calls and emails from Managers, employees, and COBRA participants to the dedicated benefits department phone and email inbox on plan provisions, benefits enrollments or any benefits inquiries
• Responds timely to a high volume of employee inquiries, evaluates eligibility, and benefits coverage based on policies and regulatory guidelines to maintain accurate benefits related records and enrollments
• Processed Qualified Medical support orders for employees of Builders’ first source.
• Assisted with design and implementation of various employee benefits programs.
• Worked well in a team setting, providing support and guidance.
• Managed time efficiently in order to complete all tasks within deadlines.
• Demonstrated respect, friendliness and willingness to help wherever needed.

● Assisted employees of Randstad and other staffing agencies with enrolling in benefits for ongoing assistance and yearly Open enrollment.

● Made 150-200 outbound calls weekly to employees to enroll in benefits and assist them.

● Upsold Aetna benefits such as Medical, Dental, Vision, Fixed Indemnity plan, STD, Accident, and Life Insurance products to the Randstad and other staffing agency employees.

● Receive about 20-30 calls daily in regards to enrolling employees into benefits.

● Assisted employees of Randstad with 1095 C tax form inquiries.

● Team Mentor during the Open Enrollment season, assisted with processing Qualifying life events and canceling benefits for other team members.

● Receive about 30-40 chats daily in regards to account inquiries and comments related to services, orders, products, or policies with DIRECTV NOW accounts.

● Post comments on Social Media for customers if they have any questions or concerns with their DIRECTV NOW service or account.

• Worked closely with each customer to carefully resolve issues within timely fashion.
• Assisted customers with order placement, product returns and order tracking.
• Monitored customer conversations and provided timely, knowledgeable assistance.
• Resolved customer complaints by identifying problems, suggesting solutions and implementing corrective action.

• Prepare moderately complex benefit calculations and trust instructions
• Collect, manipulate, reconcile, and review participant data identifying and resolving issues as they arise
• Answer plan provision questions
• Performed advanced calculations or analysis and gained an in-depth understanding of specific areas
• Work cooperatively with other team members (Towers Watson plan administrators, actuaries) to help get jobs done and to ensure unified delivery of services
• Use a thorough understanding of the plan design (e.g., coverage levels, and options, eligibility, enrollment/change, termination procedures)
• Follow and update documentation materials as directed
• Maintain complete and accurate work papers and audit trails.

• Receive about 50-60 daily in regards to phone inquiries and comments related to orders, products, or policies with the United States Mint Government accounts
• Handle all escalations professionally and with a sense of urgency to customer satisfaction on a day to day basis
• Answer inquiries while maintaining and updating the customer's information in the database, while reading and clearly comprehending the customer’s question or need
• Provide accurate and efficient order entry and maintenance of customer files when needed for the participant.
• Assisted customers by answering questions and responding to inquiries.
• Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
• Achieved high satisfaction rating through proactive one-call resolutions of customer issues.

• Received 50-60 calls a day from participants to process benefits coverage changes for the American Airlines client as well as UnitedHealth Group
• Interacted with third-party vendors, Client HR, and payroll and internal departments to resolve ongoing participant issues involving eligibility and claims
• Sorted mail and responded to participants’ letters, email and phone
• Assisted participants with questions about benefits over the client website over chat as well
• Initiated claims for participants that requested to take leaves from work
• Monitored open enrollment for over 10,000 employees by enrolling them in benefits for the next plan year, removing coverage, and anything pertaining to making changes to the participant's benefits
• Assisted the retirees of American airlines with their monthly annuities
• Offered the retirees explanations as to what their pension amounts were, as well as retiring the individual off from the company in hourly retirement sessions over the phone
• Also served as a recruiter for UnitedHealth Group for participants seeking employment within the company.
• Responded proactively and positively to rapid change.
• Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.