
Detail-oriented Business Professional skilled in managing sensitive information and ensuring client satisfaction. Delivers accurate reports on time while complying with insurance guidelines and regulations. Maintains composure in high-pressure situations and employs a diplomatic approach when collaborating with stakeholders across all levels.
• Maintain and cultivate positive relationships with clients while effectively managing interactions with external vendors.
• Prepare, review, and edit Summary Plan Descriptions (SPDs) to ensure accuracy and compliance.
• Develop and submit Requests for Proposal (RFPs) to insurance carriers.
• Create comprehensive plan comparisons and employee benefit guides.
• Coordinate and facilitate open enrollment meetings for clients.
• Assist clients with claims-related inquiries, including processing issues, resolutions, appeals, and plan exceptions.
• Serve as the primary point of contact for clients, providing support with benefit enrollments, COBRA administration, and general inquiries.
• Collaborate with insurance carriers to establish procedures or implement plan changes that achieve cost savings for employers and benefit plans.
• Track, reconcile, and update monthly commission reports for all producers within the office.
• Administered self-funded and fully insured benefit plans for more than 50 client employer groups.
• Collected and evaluated underwriting documentation, and advised prospective clients on health coverage options and rate structures.
• Delivered benefits presentations and supported the implementation of new benefit programs.
• Conducted regular on-site meetings at client locations to address benefit-related questions and concerns.
• Coordinated with internal departments, brokers, third-party administrators (TPAs), and external vendors to process changes across medical, dental, vision, 401(k), FSA, and life insurance plans.
• Prepared and distributed COBRA and HIPAA notices in compliance with regulatory requirements.
• Generated reports to assist clients with inquiries related to insurance coverage and 401(k) plans, ensuring adherence to agency standards and strict deadlines.
• Communicated complex medical and benefits information in clear, accessible terms during new hire orientations and open enrollment sessions.
• Collaborated with finance departments and vendors to reconcile payroll deductions and plan billing, ensuring accuracy in coverage and benefit deductions.
• Maintained accurate and up-to-date client and employee records within the HRIS system.
• Assisted clients with claims-related inquiries, including processing issues, resolutions, appeals, and plan exceptions.
• Partnered with insurance carriers to develop procedures and implement plan changes that achieve cost savings for employers and benefit plans.
• Administered all aspects of employee benefit programs, including medical, dental, vision, and life insurance, encompassing enrollment processing, inquiry resolution, reconciliation of monthly carrier invoices, and claims management.
• Managed the full-cycle recruitment process for shop employees, including job postings, candidate screening, interviewing, and onboarding documentation.
• Conducted new hire onboarding sessions and comprehensive benefits orientations.
• Addressed sexual harassment matters, including complaint intake, investigation support, resolution, and facilitation of training initiatives.
• Administered Family and Medical Leave Act (FMLA) and other leave of absence programs for approximately 3,000 employees.
• Handled employee relations matters, including complaint resolution and issue escalation.
• Coordinated pre-employment and random drug testing programs for both office and shop personnel.
• Managed unemployment claims, including filings and representation at hearings.
• Established and maintained accurate personnel and benefits records in compliance with organizational and regulatory standards.
• Collaborated closely with the Vice President of Human Resources on strategic and operational initiatives.
Client Relationship Management
Project and Benefits Administration
Strong Organizational Skills
Advanced Computer Proficiency
Collaborative Teamwork and Cross-Functional Support
Experience with Fully Insured and Self-Funded Insurance Plans
Knowledge of HIPAA, ERISA, and COBRA Regulations
Insurance Billing and Claims Management
Interdepartmental Collaboration and Communication
Effective Time Management and Prioritization
Research and Analytical Skills
Process Improvement and Workflow Optimization