Sharlene Ramirez
Brooksville,FL
Summary
Bilingual Benefits Specialist proudly offering many years handling health benefits enrollment for large corporations. Highly enthusiastic professional known for explaining benefits to employees in simple to understand terms. Driven to be a top performer through effective communication and interpersonal skills.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Licensed Cigna Benefit Educator
Interactive Resources Inc. / Cigna Healthcare
10.2023 - Current
- Educated customers and group employees on Cigna’s products, services, and programs such as the company’s Core: (Health, Vision, and Dental), supplemental benefits: (Critical Illness, Accident Policy, and Hospital Indemnity, through various formats including but not limited to formal presentations, Q&A sessions, benefit fairs, health fairs, and conducting webinars.
- Providing world-class customer service by creating a highly satisfying and positive experience for our customers and employees, with knowledge, competence, and professionalism.
- Cases include: Profile Products, Bowling Green, FL; City of Tamarac, Tamarac, FL; CMA CGM America LLC Containers, Miami, FL; IAFF Local 587/Firefighters, Miami, FL; Warner Music Inc Latino, Miami Beach, FL; City of Hialeah, Hialeah, FL; Alico Inc. Arcadia, FL.
Senior Field Underwriter
Equis Financial
Tamarac, FL
03.2019 - Current
- Providing a wide array of products for mortgage protection, final expense, term life annuities, and IUL's.
Licensed Benefits Enrollment Counselor
Kelly Services/ Willis Towers Watson
Troy, MI
09.2018 - 12.2024
- Explain and enroll employees into their core (Health, Vision, and Dental) as well as their group long-term and short-term disability, term life insurance, health savings account, flexible spending account, and supplemental benefits such as Whole Life, Critical Illness, and Accident Policy.
- Cases Include: 09/30/2024-11/22/2024: Miccosukee Tribe, Gaming/ Hotel/ Administration, Miami, FL (Field Enrollment); Southwire Company, Villa Rica, GA; Douglas, GA.
- 10/09/2023-12/08/2023: Miccosukee Tribe, Gaming/ Hotel/ Administration, Miami, FL (Field Enrollment); 1800 Flowers (Call Center); Flynn Restaurant Group (Call Center); Prysmian Group Willimantic, CT and Bridgeport, NJ (Field Enrollment).
- 10/10/2022 to 11/30/2022: Enlivant Senior Living, Chicago, IL; and Experimental Aircraft Association, Oshkosh WI.
- 09/01/2018 to 12/2018: Woodcliff Estates, E Hartford, CT; Medline Industries Inc. Plants in Indianapolis, IN, and Shepherdsville, KY.
HR Benefit Specialist
Accountable Healthcare Staffing
Boca Raton, FL
01.2023 - 06.2023
- Company Overview: Professional Employer Organization
- I notified newly eligible employees of their enrollment process for health and welfare benefits on a weekly basis, submitted weekly files to enrollment vendor, determined eligibility for per diem healthcare practitioners (HCPs) and Affordable Care Act (ACA) on a monthly basis.
- I worked with branches to resolve benefit eligibility and enrollment issues, managed and maintained benefit eligibility process for high volume of contract employees in Excel (Trackers), I assisted in the development and communication of benefits policies, open enrollment procedures and other necessary employee communication and presentations.
- I provided customer service support to internal and external customers, I helped employees with benefit issues (eligibility, enrollment, claims, etc.).
- I responded to inquiries from the benefits telephone lines, e-mails and delegate calls based on the inquiries.
- I conducted quarterly deduction audits to ensure the correct benefit premiums are being collected, Implemented, and maintained group benefits databases and benefits records, as well as other duties assigned by Human Resources staff based on business needs or management’s request.
- Human Resources Information Systems (HRIS) Used: Stafferlink, PlanSource, Ceridian Dayforce, and Aetna carrier’s portal for Health, Dental/ Vision.
Membership and Enrollment Specialist /Billing and Underwriting/ Member Escalations Team/ Pharmacy Specialist
MEDIX Staffing Solutions/ Bright HealthCare
Chicago, IL
03.2021 - 12.2022
- Works within a team providing Level 1 support by answering incoming calls regarding Enrollment, Eligibility, and/or Premium Billing Questions, collaborates with internal and external Bright Health Partners to resolve Level 1 Enrollment and Eligibility issues.
- Facilitates the collection of outstanding premiums, Works with State-based exchange and Federal Facilitated Marketplace (FFM) to resolve Level 1 enrollment, premium, APTC/CSR disputes, or discrepancies.
- Participates in the discovery and resolution of the root cause for recurring issues, works with Members in a grace period to resolve billing issues and/or collect outstanding premium.
- Ensures that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships, removed holds/flags from pharmacy screen after payment for the Member to be able to reprocess claims to get their RX, and I also created pharmacy profiles for new Members.
Benefits Specialist
Stafflink Outsourcing Inc.
Sunrise, FL
07.2020 - 02.2021
- Company Overview: Professional Employer Organization
- Worked within a team to assist in the administration of employee benefit plans for many clients across multiple states
- These benefit plans include major medical, dental, vision, life and ADD, retirement, disability, and other ancillary benefits.
- Managed client group insurance renewals, and the ongoing administration of all benefit plans.
- Served as the subject matter expert regarding qualified Health and Welfare Plan benefit plans, products and services; Administered benefit enrollments, changes, terminations, COBRA and the annual open enrollment process for PEO Multiple Employer Plans and client sponsored health, dental, vision, 401(k), and other supplemental plans.
- Provided compliance information regarding the ACA, Section 125, COBRA, 401(k), and carrier participation and contribution regulations.
- Prepared communication and materials for optimal enrollment presentations; Entered PEO and client sponsored employer contributions, employee deductions, and credit-back deductions.
- Reviewed payroll reports to ensure proper employer and employee payroll charges; Reconciled monthly insurance billings such as medical, dental, life, and supplemental plans, and keys catch-up and refunds as appropriate.
- Responded to correspondence, email, and phone calls from clients, employees, and vendors; Maintained files and/or scans documents as applicable; Ensured accurate information is provided in benefit documents.
- Ensured documentation is completed timely and thoroughly; Assisted with annual open enrollment to ensure each client is handled as directed.
- Provided customer service support to internal and external customers; Provided support to clients and employees.
Skills
- Fluent in Spanish and English
- Proficient in Excel, PowerPoint, Access, InfoPath, Outlook, and Word
- Proficient in writing letters, memos, and emails
- Benefits interpretation
- Benefits explanation
- Telephone skills
- Listening skills
- Leadership skills
- Time management
- Decision-making abilities
- Proficient in enrollment platforms: PLANEbiz, Benefits Connect, ADP, Common Census, Smart Ben Essentials, Allstate, Selerix, Falcon, Benefit Selection, PeopleSoft, Harmony (Colonial Life), Lawson, UltiPro, PlanSource Enrollment Platform, and Empyrean
Certification
- 2-15 License/ FL: W022051
- 2025 FFM Individual Marketplace Certification Completed NPN: 16011819
- 2024 SHOP Marketplace Certification Completed NPN: 16011819
- 2024 AHIP Medicare + Fraud, Waste, and Abuse Training Certification Completed NPN: 16011819.
References
References available upon request.
Timeline
Licensed Cigna Benefit Educator
Interactive Resources Inc. / Cigna Healthcare
10.2023 - Current
HR Benefit Specialist
Accountable Healthcare Staffing
01.2023 - 06.2023
Membership and Enrollment Specialist /Billing and Underwriting/ Member Escalations Team/ Pharmacy Specialist
MEDIX Staffing Solutions/ Bright HealthCare
03.2021 - 12.2022
Benefits Specialist
Stafflink Outsourcing Inc.
07.2020 - 02.2021
Senior Field Underwriter
Equis Financial
03.2019 - Current
Licensed Benefits Enrollment Counselor
Kelly Services/ Willis Towers Watson
09.2018 - 12.2024
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