Summary
Overview
Work History
Education
Skills
Timeline
Generic

Loren Baltimore

Montgomery,IL

Summary

Dedicated Human Resources professional with a niche for leveraging 10+ years of customer service experience to maintain employee relations. Proficient in many facets of the HR function, with an emphasis on benefits and leaves of absence. Through collaboration and a strategic approach, constantly aiming to enhance company culture, streamline processes to impact the bottom line, and improve vendor alliance.

Overview

12
12
years of professional experience

Work History

HR Benefits Coordinator

Univar Solutions
Downers Grove, IL
08.2020 - Current
  • Collaborate with vendors to execute regular communication to employees about plan offerings as well as find root-cause and resolutions as appropriate.
  • Process all necessary status changes for employees on leave of absence in the HRIS system and monitor absence duration according to their approval status.
  • Update timecards for employees on leave of absence, including calculating appropriate payment.
  • Create, settle, and track invoices to ensure accurate and timely payments to vendors.
  • Partner with payroll regarding benefit deduction inquiries.
  • Monitor the shared Benefit Team email boxes and respond to employee, manager and HR inquiries on benefit matters regarding eligibility, coverage and provisions.
  • Identify common trends and implement solutions to improve the process and/or experience for employees.
  • Regular and custom reporting, including basic data analysis.
  • Maintain tracking spreadsheet for ADA requests, medical and personal leaves.
  • Complete weekly 401K plan reconciliation, funding and service requests for plan administrator.
  • Assist with audits by preparing accounts and providing information.

Senior Fraud Recovery Resolution Specialist

UnitedHealth Group Telecommute
08.2017 - 08.2020
  • Provide claims expertise support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
  • Analyze, identify trends and provide reports as necessary
  • Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
  • Manage subrogation files
  • Serve as primary contact for fraud claim inquiries

Provider Benefits Resolution Specialist

UnitedHealth Group, Telecommute
Moline, IL
12.2016 - 08.2017
  • Provide expertise to providers regarding benefits, claims and authorizations
  • Analyze scenarios to find root cause of problems and offer acceptable resolutions
  • Utilize resources to research policies, procedures, and guidelines to ensure accuracy of information
  • Provide one call resolution and/or follow up for solutions
  • Create, update and route provider authorizations appropriately
  • Provide claim status, review, and or appeal procedures
  • Advise providers if authorizations or notifications are necessary.

HR Benefits Representative

John Deere
Moline, IL
05.2016 - 12.2016
  • Provide benefit information to employees and retirees
  • Employee point of contact, advocate and case manager for assigned human resource processes such as pension and employee purchase plan
  • Research, resolve, and respond to general employee concerns
  • Enroll, terminate, and change medical, dental, vision coverage according to plan guidelines
  • Review vital documents for benefit eligibility verification
  • Educate on Medicare requirements and supplemental coverage
  • Research employee benefit and health and safety practices, recommending changes or modifications to existing policies.
  • Administer employee insurance, pension and savings plans.

Technical Support Advisor

Verizon Wireless
Elgin, IL
10.2013 - 07.2015
  • Answer level two technical support calls for device and service issues
  • Provide solutions for device replacements through warranty, insurance, or eligible upgrades when necessary
  • Troubleshoot network service issues
  • Identify outages and escalate to network support for resolution
  • Educate on high risk applications
  • Maintain proficiency in IOS, Windows, and Android operating systems
  • Proactively offer additional products and services
  • De-escalate calls when speaking with irate customers
  • Assist customers with various types of technical issues via email, live chat and telephone.

Eligibility Specialist

Maximus
Chicago, IL
12.2012 - 09.2013
  • Initiate Medicaid redeterminations by sending letters to recipients
  • Review recipient vital documents to determine eligibility for benefits
  • Recommend eligibility or ineligibility to state case workers for Medicaid benefits
  • Recommend specific Medicaid program based on eligibility factors
  • Answer escalated calls from customer service representatives in regards to redetermination process

Education

Some College (No Degree) -

Waubonsee Community College
Sugar Grove, IL
05.2012

High School Diploma -

West Aurora High School
Aurora
06.2005

Skills

  • Benefits program administration and interpretation
  • Open enrollment
  • HRIS applications
  • Microsoft Office Suite
  • Documentation review
  • Background in medical insurance including medicaid and Tricare
  • Insurance plan verification
  • Medical terminology
  • Claims resolution
  • Invoice processing
  • Spreadsheet management
  • Data Entry

Timeline

HR Benefits Coordinator

Univar Solutions
08.2020 - Current

Senior Fraud Recovery Resolution Specialist

UnitedHealth Group Telecommute
08.2017 - 08.2020

Provider Benefits Resolution Specialist

UnitedHealth Group, Telecommute
12.2016 - 08.2017

HR Benefits Representative

John Deere
05.2016 - 12.2016

Technical Support Advisor

Verizon Wireless
10.2013 - 07.2015

Eligibility Specialist

Maximus
12.2012 - 09.2013

Some College (No Degree) -

Waubonsee Community College

High School Diploma -

West Aurora High School

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Loren Baltimore