Rachel Jones
Peoria,AZ
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
18
18
years of professional experience
Work History
Sr. Claim Benefits Analyst
AETNA
01.2016 - Current
- Liaison between clients and stop loss carriers
- Reviews and manages stop loss claim filings
- Conduct financial audits of each claim submission for accuracy and collect all pertinent information necessary for filing
- Resolves discrepancies between amounts requested and amounts reimbursed by stop loss carriers
- Provide reports as requested by clients.
Benefits Specialist
Managed Staffing on site at Aetna
01.2015 - 01.2016
- Liaison between clients and stop loss administrators
- Reviews and manages stop loss claim filings which includes conducting financial audits of each claim submission for accuracy and collecting all pertinent information necessary for filing
- Resolves discrepancies between amounts requested and amounts reimbursed by stop loss carriers
- Provide reports as requested by clients.
Human Resource
Brainz LLC Staffing Agency
01.2014 - 01.2015
- Manage all employees’ files, coordinates and administer HR policies and procedures
- Handles scheduling and staffing processes, including staff selection, manage client scheduling and service
- Manage issue resolution, time sheet tracking, and provides customer service to employees and contracted facilities.
Client Benefits Specialist
HANRATTY & ASSOCIATES
01.2006 - 01.2012
- Administered COBRA, enrollment eligibility, open enrollment packets, reports, maintained manual and automated records, educated participants, and responded to detailed inquiries in timely and accurate manner for both clients and participants
- Managed COBRA department and helped clients stay current with COBRA laws and regulations
- Implemented new procedures
- Increased customer-satisfaction ratings
- Enhanced employee performance with daily mentoring, one-on-one discussions, and motivational strategies
- Managed, reviewed and monitored ongoing client issues and deliverables
- Accountable for testing and quality review of client specific documents
- Consistently documented administrative processes and procedures
- Deftly developed and implemented best practices
- Provided plan documents and followed administrative procedures related to benefit calculations
- Constantly updated spreadsheets and calculated procedures
- Actively answered helpline calls from participants, recorded calls, followed-up with research on participant questions and paperwork for file
- Strong working knowledge of federal and state regulations including ERISA, HIPPA, FMLA etc.
- Excellent Interpersonal, partnering and communication skills, both written and oral
- Ability to maintain high level of confidentiality regarding employee information
- Received outstanding positive comments from team members on employee reviews.
Education
Master of Arts - Human Resource Management
SAINT MARY’S UNIVERSITY OF MN
Minneapolis, MN01.2018
Bachelor of Arts - Human Resource Management
METROPOLITAN State University
Saint Paul, MN05.2014
Skills
- Benefits Administration
- Verbal and written communication
- Relationship Building
- Documentation And Reporting
- New employee orientations
- Attention to Detail
- Records Maintenance
- Employee Relations
- FMLA comprehension
- Special projects
- Benefits Explanation
- New employee enrollment
Timeline
Sr. Claim Benefits Analyst
AETNA
01.2016 - Current
Benefits Specialist
Managed Staffing on site at Aetna
01.2015 - 01.2016
Human Resource
Brainz LLC Staffing Agency
01.2014 - 01.2015
Client Benefits Specialist
HANRATTY & ASSOCIATES
01.2006 - 01.2012
Master of Arts - Human Resource Management
SAINT MARY’S UNIVERSITY OF MN
Bachelor of Arts - Human Resource Management
METROPOLITAN State University
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