Performance-driven, insightful Training Professional with a proven ability to achieve and exceed all business-development and educational standards in high-pressure environments. Skilled at consulting with clients to delineate and analyze their situations and develop strategic solutions to achieve their goals. Relationship-development expertise that complements the ability to aggressively build solid client rapport. Comprehensive knowledge of and experience in leveraging numerous educational and financial instruments in a variety of complex scenarios.
Overview
43
43
years of professional experience
1
1
Certification
Work History
Provider Relations
Ohio Department of Medicaid
2016.05 - 2024.04
Under general supervision, based on Medicaid policies rules and regulations: reviews & responds to a high volume of problem medical claims received from medical providers which were rejected for Medicaid payment or are unpaid; Utilizes Medicaid Information Technology System (MITS) to retrieve various subsystems (e.g., claims processing & procedures, drug & diagnosis to verify utilization criteria & code validity, recipient to verify consumer eligibility, prior authorization to verify approvals, denials & referrals); interpret Medicaid, waiver, & other medical assistance program policies, billing instructions &/or claim processing procedures to resolve provider inquiries/complaints; explains decisions made to providers; determines whether system override codes should be applied to claim for processing e.g., may apply override codes to clear claim for processing
Responds to inquiries and/or requests for information regarding the Department of Medicaid's (ODM) Automated Registry Check System (ARCS) from external medical providers and/or current ARCS users
Associate
Fiserv
2013.06 - 2015.12
Develop a strong rapport with banks, credit unions and their clients to resolve account fraud. - Effective communication (written & verbal) of fraud regulations and process with account holders. - Issue credits - create and resolve cases using the VISA/Master Card Systems
Increased customer satisfaction by resolving complex issues and providing exceptional service at all times.
GSPS Client Representative
Morgan Stanley
2012.07 - 2013.01
Assist clients placing trades within their Employee Stock Purchase Plans, Restricted Stock Plans and Stock Option Accounts. - Resolve escalated issues and educate clients in regards to their Employee Stock Plans. - Assist and educate clients about the benefits of utilizing the online access which provides tools and vital information to manage their accounts.
Farmers Insurance Agent
Kerry J. Kay Agency
2011.01 - 2012.02
Collaborated with clients to identify and select investment product investment solutions. - Design appropriate retirement income and financial plans. - Managed client accounts for Life, Health and Property & Casualty Policyholders.
Maintained accurate records of client communications, transactions, policies, and other relevant documentation for seamless operations within the agency.
Resolution Team Lead
Medco Pharmacy
2008.01 - 2011.01
Resolve highly escalated client issues utilizing Accounting, in house and retail pharmacies and Physicians while coordinating with insurance company policy to insure delivery of medications to our clients - Patient liaison and advocate on all pharmaceutical needs; filed insurance forms; organized and maintained files detailing patient information including medications, reimbursements due, and cash-flow requirements. - Routinely consulted with multidisciplinary physician groups and medical support personnel
Home Care Provider
Self FBO Margaret Kay
2006.01 - 2008.01
Collaborated with physicians, medical support teams, and respite care services to develop and execute a proactive home care program that ensured the safety and welfare of the patient while optimizing care.
Senior Trainer
Nationwide Retirement Solutions
1996.01 - 2006.01
Educate external and internal Financial Representatives to ensure production of revenue levels and territory profitability. - Lead teams in investment product sales and delivery of customer relationship management techniques. - Collaborate with clients and team members to assess individual financial situations and develop strategic financial planning solutions. - Education of all staff includes IRC tax law, NASD 6, Life & Health, AS400, internet, data entry, operational processes, financial planning, securities transactions and funds transfers. - Development and delivery of educational curriculum and standards for all internal and external representatives.
Streamlined onboarding processes for new hires, accelerating their integration into job roles.
Analyzed training, student outcomes and course delivery metrics to produce reports for senior management.
Evaluated training needs to improve training quality.
Oversaw day-to-day functions of training department.
Coordinated training for new hires to impart information about company policies, requirements and performance strategies.
Developed and implemented lesson plans and teaching aids such as reference materials and videos.
Maintained standardized training programs by providing comprehensive in-house training to new employees and newly graduated and hired officers.
Equity Sales / Registered Representative
Nationwide Insurance
1984.02 - 1989.02
Managed the national sales of three investment products which included a Single Premium Life, Variable Life and Variable Annuity
Track, Forecast & Report National Sales to Board
Developed strong relationships with clients through regular communication and portfolio reviews, resulting in increased trust and retention rates.
Collaborated with internal departments such as compliance and operations to address any concerns or issues impacting client accounts, ensuring a seamless customer experience.
Kept abreast of all changes in stock market and investments to better manage client finances.
Repurchase Agreement Trader
Bank One Investments
1981.06 - 1984.02
Traded US Treasuries for pledging as collateral on short term investment products. - Report, balance, reconcile trades, calculate and apply interest, make General Ledger Entries
Created daily market recaps and profit and loss information to [Number] senior traders at close of each trading day.
Education
American Banking Association Financial Instruments -
Columbus Technical Institute
Columbus, Ohio
Skills
Performance Consulting
Presentations
Product Marketing
Leadership / Motivation
Client Relations
Curriculum Development
Process Improvement
Team and Consensus Building
Financial product knowledge
Strong analytical skills
Relationships and rapport
Negotiation Techniques
Regulatory Compliance Knowledge
Asset Allocation Strategies
Certification
Ohio Life & Health Licensed
Certified Retirement Counselor
Activities
President of PAC on Residential Development in Hilliard- ACCORD (6 years)
Member of Vestry Trinity Episcopal Church (3 years)
Acolyte Guild Director Trinity Episcopal Church (7 years)
Youth Ministry Director Trinity Episcopal Church (7 years)
Head Football & Basketball Coach (24 years)
Named One of “Nine Most Influential People in City of Hilliard” SNP Publications
Continuing Education
Langevin Education and Presentation Training
Bob Pike Performance Consulting
Training
TRAINING - FINANCIAL SERVICES - CUSTOMER RELATIONS
Timeline
Provider Relations
Ohio Department of Medicaid
2016.05 - 2024.04
Associate
Fiserv
2013.06 - 2015.12
GSPS Client Representative
Morgan Stanley
2012.07 - 2013.01
Farmers Insurance Agent
Kerry J. Kay Agency
2011.01 - 2012.02
Resolution Team Lead
Medco Pharmacy
2008.01 - 2011.01
Home Care Provider
Self FBO Margaret Kay
2006.01 - 2008.01
Senior Trainer
Nationwide Retirement Solutions
1996.01 - 2006.01
Equity Sales / Registered Representative
Nationwide Insurance
1984.02 - 1989.02
Repurchase Agreement Trader
Bank One Investments
1981.06 - 1984.02
American Banking Association Financial Instruments -
Columbus Technical Institute
Ohio Life & Health Licensed
Certified Retirement Counselor
Similar Profiles
Christine ColeChristine Cole
External Audit Manager at Ohio Department of MedicaidExternal Audit Manager at Ohio Department of Medicaid