Summary
Overview
Work History
Education
Skills
Additional Information
Work Preference
Skills
Certification
References
Timeline
Receptionist

Tania McCauslin

Associate Benefits Consultant
Schenectady,US

Summary

Results-driven Associate Benefits Consultant with a strong track record in designing and implementing customized employee benefits packages. Expertise in navigating small to mid-market clients through benefit selection while ensuring compliance and client satisfaction. Skilled in project coordination, client management, and benefit analysis, with a commitment to optimizing processes and enhancing customer service. Proficient in utilizing advanced tools and software to deliver high-quality results across complex accounts.

Overview

29
29
years of professional experience
1
1
Certification

Work History

Associate Benefits Consultant

GTM Insurance
02.2024 - Current
  • Support the Senior Account Manager with the architecture of tailor-made benefits packages for clients
  • Play a pivotal role in crafting and delivering top-tier employee benefits and expertise to guide small and midmarket clients through selection, customization and ongoing management, ensuring both satisfaction and compliance with regulatory standards
  • Take customer service calls answering questions about health insurance, workman's comp and disability
  • Perform audit for clients on United Healthcare, CDPHP ext
  • Load new clients on to Employer Navigator and maintain it
  • Sign up new clients for disability
  • Write up work flows and help train new hires

Implementation Coordinator

Anthem, Inc. (Previously Empire Blue Cross Blue Shield)
11.2011 - 08.2023
  • Receive completed sales package/gain form and Salesforce Tasks
  • Evaluated gains from, Salesforce tasks to maintain completeness.
  • Checked discrepancies in documents through collaboration with Sales.
  • Validated benefits and rates, ensuring appropriate signoff for non-standard inclusions.
  • Created JIRA tickets needed for both standard and non-standard benefits.
  • Monitored the progress of JIRA tasks until completion.
  • Created project plan, Benefit plan design and Group structure document for large complex accounts
  • Oversaw the creation and delivery process for ID cards.
  • Generated and distributed applicable group contracts, schedules of benefits, and financial service agreement Riders.
  • Ensure Installations Access Database is completely updated
  • Hold Client meeting and produce the Decisions and Deliverables list and send out meeting minutes after holding the meetings
  • Supported the integration of new team members into company processes.

Membership & Billing Reconciliation Representative

Anthem, Inc. (Previously Empire Blue Cross Blue Shield)
09.1996 - 11.2011
  • Maintain Applications and coverage for subscribers through verbal and written correspondence with Appointed Group Benefit Administrators
  • Resolve routine and complex written and telephone/hotline inquiries involving enrollment, eligibility, billing and premium payment from external customers and Group Benefit Administrators
  • Specifically responsible for training of new hires
  • Volunteer to learn Aces to help process Connecticut's work
  • Assist other departments as needed including Direct Pay, Child Health Plus, Customer Service, Small Group

Education

Certificate - Life/Accident & Health

Bryant & Stratton College
Albany, NY

Certificate - Information Processing

Educational Opportunity Center - Hudson Valley Community College
Troy, New York

High School Diploma -

Bethlehem Central High School
Delmar, New York

Skills

  • Benefits administration
  • Regulatory compliance
  • Project management
  • Client relationship management
  • Data analysis
  • Salesforce management
  • JIRA management
  • Employee training
  • Meeting facilitation

Additional Information

Excellent communication skills - written and verbal., Very thorough and detail oriented., Enjoys providing quality service to consumers.

Work Preference

In-office or remote roles

Skills

  • Typing: 70 wpm

Certification

  • Life, Accident and Health, Travel Accident

References

References available upon request.

Timeline

Associate Benefits Consultant

GTM Insurance
02.2024 - Current

Implementation Coordinator

Anthem, Inc. (Previously Empire Blue Cross Blue Shield)
11.2011 - 08.2023

Membership & Billing Reconciliation Representative

Anthem, Inc. (Previously Empire Blue Cross Blue Shield)
09.1996 - 11.2011

Certificate - Life/Accident & Health

Bryant & Stratton College

Certificate - Information Processing

Educational Opportunity Center - Hudson Valley Community College

High School Diploma -

Bethlehem Central High School

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Tania McCauslinAssociate Benefits Consultant