Stephanie Atencio
Healthcare Operations
Marble,NC
Summary
Experienced Healthcare Account Specialist proficient in data verification, account updates and problem solving. Deep understanding of Healthcare DOI rules as well as customer service and sales activities. Bringing 7 years of related experience.
Overview
8
8
years of professional experience
Work History
Account Implementation Specialist III
BLUE CROSS BLUE SHIELD OF NC
, Telework, NC
01.2019 - Current
- Customize, Execute and Implement custom group health insurance plans for high-profile large, major and national accounts.
- Establish strong relationships with internal and external partners that support new and renewal business: Sales, IT, Configuration, Compliance, Claims, Legal, Underwriting, Agents, Brokers, HR administrators, CEOs and CFOs.
- Independently manage multiple customer implementations, projects, applications and enrollments from beginning to end.
- Collaborate with internal teams and third-party vendors within time constraints.
- Develop project plan timelines which are shared with brokers, agents, clients while setting communication channel expectations.
- Lead "Kick-off" calls with internal and external teams.
- Build 500+ health benefits and present those documents for client review and approval.
- Create and upload Summary of Benefits and Coverages (SBC).
- Create custom ID cards, enter medical codes into internal systems, approve member booklets, establish group invoice and billing structures, oversee installment of eligibility files.
- Prepare forms for renewing and new business: Group Applications, ERISA, Agent fee agreements (AFA), wellness program selection forms, renewal change forms (RCF), pharmacy benefits manager (PBM), basic pivot tables, Requests for Proposals (RFP).
- Proficient with Adobe Acrobat Pro, Salesforce.com, Excel.
- Support sales and marketing team with demos and Requests for Proposals (RFP).
- Critical thinker with ability to understand technical products and explain complicated concepts to non-technical audiences.
- Current Life and Health State licensure: NCStephanie Atencio 720.388.9750.
Sales, Licensed Health Insurance Agent
HEALTHCARE SOLUTIONS TEAM
01.2016 - 01.2019
- Develop leads and manage an active pipeline of qualified prospects and generate leads from personal contacts, cold calling, networking and referrals.
- Assist customers with filing claims, locating in-network doctors and hospitals, understanding policy benefits and exclusions, enrolling in health plans, act as a liaison between the health insurance provider and customer.
- Develop a sales and marketing plan to compete with other producers.
- Responsible for gathering all required information to obtain quotes.
- Prioritize customer escalations and respond to needs.
- Web based presentations which teach and educate customers on health insurance options and current regulatory requirements.
Claims
NATIONWIDE INSURANCE COMPANY
Denver, CO
01.2014 - 01.2016
- Homeowner Property Damage & Auto Claims Liability Adjuster.
- Investigate and settle third-party liability Homeowner Property Damage claims such as water losses, tree damage, dog bites, and fire losses.
- Set reserves in accordance with company practices.
- Review property damage estimates and pay accordingly.
- Partner with SIU (Special Investigations Unit) to identify potential fraudulent activity.
- Consult the subrogation team regarding financial recovery.
- Deliver liability decisions over the phone and through written correspondence.
- Work with managers to solve more complex, high-dollar losses.
- Determine proper policy coverages for first-party insureds.
- Achieve QA (Quality Assurance) of 100% claim accuracy.
- Investigate and resolve auto liability claims via telephone, internet and email.
- Record and document statements from insureds, claimants and witnesses.
- Correspond with insureds and claimants via mail, fax, email and phone according to best claim practices.
Education
Bachelor of Arts -
Western State Colorado University
Skills
Customer relationship development
Research proficiency
Issue investigations
Documentation skill
Business Development
Timeline
Account Implementation Specialist III
BLUE CROSS BLUE SHIELD OF NC
01.2019 - Current
Sales, Licensed Health Insurance Agent
HEALTHCARE SOLUTIONS TEAM
01.2016 - 01.2019
Claims
NATIONWIDE INSURANCE COMPANY
01.2014 - 01.2016
Bachelor of Arts -
Western State Colorado University