Lourdes Abreu
Weymouth,MA
Summary
Dynamic professional with a robust background in the health insurance industry. Demonstrates expertise in regulatory knowledge and HIPAA compliance, alongside mentoring peers for improved productivity. Contributes to policy development and team collaboration.
Overview
7
7
years of professional experience
Work History
Contracts Analyst
Blue Cross Blue Shield of Massachusetts
08.2022 - Current
- Support the development of new and revised policy forms and contracts for all product lines and financial arrangements by proof‐reading and reviewing documents, drafting new language, and drafting new riders.
- Actively support the sales and service processes and workflows by analyzing nonstandard benefit requests and providing thorough, accurate, and timely responses.
- Ensure that all member and account contracts are prepared and issued in accordance with corporate policies and procedures.
- Actively participate in the implementation of state and federal mandates, new products, product changes, and corporate initiatives by attending workgroup meetings, analyzing changes, documenting impacts, drafting new language, and making updates to Product Master and BARS.
Case Management Extender
Blue Cross Blue Shield of Massachusetts
01.2019 - 01.2021
- Educate high-risk members on case management serves and coordinate appointments for clinical outreach
- Communicated with clinical team regarding issues related to case management, resourcing, service collaboration and development of new resources.
- Supported colleagues through mentoring and sharing best practices, promoting a culture of continuous learning within the team.
- Informally mentored new extenders, answering questions, offering opportunities to shadow and observe and explaining basic information about company procedures.
Member Service Representative
Blue Cross Blue Shield of Massachusetts
01.2018 - 12.2019
- Enhanced member satisfaction by efficiently addressing and resolving inquiries and concerns.
- Served as a mentor for new hires sharing best practices contributing towards increased productivity among team members.
- Collaborated with team members to ensure seamless operations during peak hours or staff shortages.
Education
Bachelor of Science - Biology
Associate of Arts - Liberal Arts And Sciences
05.2014
Skills
- Microsoft Office
- Document Review
- Drafting Agreements
- Regulatory knowledge
- Customer Service
- Research and data collection
- HIPAA Compliance
- Salesforce
Timeline
Contracts Analyst - Blue Cross Blue Shield of Massachusetts
08.2022 - Current
Case Management Extender - Blue Cross Blue Shield of Massachusetts
01.2019 - 01.2021
Member Service Representative - Blue Cross Blue Shield of Massachusetts
01.2018 - 12.2019
University of Massachusetts Amherst - Bachelor of Science, Biology
Mount Wachusett Community College - Associate of Arts, Liberal Arts And Sciences
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