Gregory Littlejohn

Perform routine benefits administration and case processing activities including, but not limited to: processing benefit applications, Qualified Domestic Relations Orders, POAs, Newly Trusteed Plans and other documents; entering data into PBGC (Pension Benefit Guaranty Corporation) systems of record; conducting research for participant issues; supporting payment recovery and benefit payment processing activities; issuance of benefit determination letters; authorizing benefit payments; conducting quality reviews to ensure work meets quality standards; and handling complex or sensitive case processing or customer matters.

• Retirement Plan Administration

● Execute oversight and analysis for activities including calculating earnings and losses and account valuations

● Verifying data on payments and accompanying documents, processing documents according to a customer’s detailed instructions and document review

● Provide input on how guidelines and processes may be improved

● Obtain and/or validate client information; updates information in all applicable systems

● Deliver high-quality customer service when responding to inquiries made by telephone and written

correspondence

• Manages and supports all human resource-related processes in the HR department
• Performed billing and coding; managed insurance claims, invoices, and payments
• Updated schedules to reflect changes or shifts in project timelines
• Maintains personnel records, updates databases, and creates guidelines and FAQ documents about company policies
• Provided administrative and clerical support to ensure efficient operation of the office
• Supported management and employees through a variety of tasks
• Train and educated employees
• Prepare and manage HR documents
• Organized and scheduled appointments and meetings

• Wrote, evaluated, and executed various contracts covering a range of transactions related to Electronic Visit

Verification in the state of Florida

● Conducted monitoring and technical assistance for Fee for Service programs and managed prior authorization

and utilization management contracts

● Conduct additional due diligence on accounts not adhering to contractually agreed upon rules/guidelines, with a

focus on mitigating potential losses or misuse.

● Acts as initial review point for (potential) fraudulent claims

● Managed invoices & purchase orders, and partner with leadership and finance to track and analyze departmental

budgets, and expenses

Identified claims with potential waste and abuse

● Upheld documentation and process standards

● Developed and maintained relationships with suppliers and customers

● Managed team mailbox and responded or directs inquiries appropriately

● Instructed end users in the appropriate use of equipment, software, and/or reference materials

● Provided initial review and research to help determine if claims require further investigation to determine

possible fraudulent activity

● Supported the production of investigation reports to internal and external stakeholders by compiling and storing

evidence appropriately

● Assisted other departments in the design of quality edit checks to ensure data quality objectives are met, as well

as participate in cross-functional teams on development and improvement

• Resolved technical issues and ensures the completion of tests in accordance with required schedule.

● Contacted providers requesting documents and confirming information

• Managed, developed, and executed formal test plans in collaboration with product owners and software development teams

● Collected and analyzing data to identify trends, diagnose problems, and create solutions to solve problems

• Implementation and execution experience in quality assurance processes.

● Created charts, tables, presentations, and other forms of data visualization.

● Communicated and presented new information to the necessary stakeholders and translated their needs into

organizational goals