Ginger Wilson
Birmingham,AL
Summary
I have over 28 years experience in the healthcare industry. I am a results-driven individual with a solid track record in delivering quality work. I have solid communication and teamwork abilities with a commitment to achieving company goals and delivering exceptional service along with high attention to detail and problem solving skills.
Overview
35
35
years of professional experience
Work History
Retired
Blue Cross and Blue Shield of Alabama
Birmingham, AL
11.2018 - Current
Reinsurance Analyst
Blue Cross and Blue Shield of Alabama
Birmingham, Alabama
03.2015 - 11.2018
- Collect and submit monthly stop loss reporting, required documentation to stop loss carriers
- Identify, track and report members that meet their specific stop loss deductible and aggregate, if included
- Accurately complete eligibility forms, provide enrollment documentation and ensure all leave time documented complies with client’s policies
- Reconcile and resolve reimbursement discrepancies; provide additional reporting and explanation as needed
- Worked with claims/ benefits department regarding any adjusted claims with stop loss issues
- Worked with BCS, Sun Life, Lloyds of London and consulting firms of all clients; liaison between stop loss carrier, client teams and medical/pharmacy claims
- Perform year end stop loss policy reviews to include aggregate calculations and ensure all claims have been submitted and reimbursements have been issued
Senior Analytics Consultant
Blue Cross and Blue Shield of Alabama
Birmingham, AL
08.2006 - 03.2015
- Responsible for large group specific cost and utilization reports, ad-hoc reports, data analysis, identifying trends and book of business and researching data issues for such groups as Auburn University, Community Health Systems, Thompson Tractor, University of Alabama (Account Executive groups)
- Generate customized reporting for internal and external customers utilizing multiple databases and applications including Crystal Reports, Excel, Power Point, Word, Advantage Suite and Tableau for Executive Summaries
- Senior leader responsible for the Retiree Drug Subsidy (RDS) Program through CMS (Center for Medicare and Medicaid Services) for groups under Blue Cross and Blue Shield of Alabama; plan sponsors approved through CMS; organizing, maintaining workflow and yearly reconciliation for all data
- Maintain leadership role in department by providing training to new associates on reporting tools and cost and utilization systems as well as providing data and analytical tool reporting expertise to associates on a daily basis
- Reporting on clinical data issues for internal customers using Advantage Suite and Tableau data sources
- Attend CEU sessions for current issues and healthcare reform
- Conduct formal presentations to customer’s top management, consultants and key decision makers
Marketing Business Analyst
Blue Cross and Blue Shield of Alabama
Birmingham, AL
03.2000 - 08.2006
- Responsible for group specific cost and utilization reports, ad-hoc reporting, data analysis, identifying trends and researching data issues
- Prepared executive summaries and conducted formal presentations to management, customers and consultants
- Customized reporting for internal and external customers utilizing multiple databases such as Crystal reports, HDMS, Excel, PowerPoint and Word
- Submitted data request for cost reporting and stop loss reporting
- Worked closely with Marketing Sales team and Executives, group decision makers and consultants
Finance-Underwriter
Blue Cross and Blue Shield of Alabama
Birmingham, AL
01.1995 - 03.2000
Human Resources-Compensation & Benefits Specialist
Blue Cross and Blue Shield of AL
Birmingham, AL
05.1990 - 01.1995
Education
BBA - Accounting
Jacksonville State University
Jacksonville, AL12-1985
Skills
- Strong analytical and problem solving skills
- Self starter with ability to work independently as well as be a good team player
- Strong organizational skills, ability to prioritize, and manage multiple requests and projects in a fast-paced environment while maintaining attention to detail
- Experienced in Excel, PowerPoint, Crystal
- Strong verbal, written and interpersonal communication skills
- Ability to prioritize and manage multiple requests and projects in a fast-paced environment while maintaining attention to detail
Timeline
Retired
Blue Cross and Blue Shield of Alabama
11.2018 - Current
Reinsurance Analyst
Blue Cross and Blue Shield of Alabama
03.2015 - 11.2018
Senior Analytics Consultant
Blue Cross and Blue Shield of Alabama
08.2006 - 03.2015
Marketing Business Analyst
Blue Cross and Blue Shield of Alabama
03.2000 - 08.2006
Finance-Underwriter
Blue Cross and Blue Shield of Alabama
01.1995 - 03.2000
Human Resources-Compensation & Benefits Specialist
Blue Cross and Blue Shield of AL
05.1990 - 01.1995
BBA - Accounting
Jacksonville State University
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