Tasha Williams-Davis

• Develops standard and customized member enrollment materials by translating data-driven tools into Booklets, Contracts, and Summaries of Benefit Changes Documents, ensuring clear and concise communication to stakeholders
• Utilizes effective project management techniques to coordinate activities with all levels of staff within the plan and external agencies, demonstrating clear and concise verbal and written communication skills, as well as diplomatic and persuasive negotiation abilities with stakeholders
• Apply advanced knowledge of the health insurance plans, including benefit design and compliance and regulatory advances with capability of translating into contracts and other related materials
• Conducts research and analyzes the progressive knowledge of State and Federal laws and regulations to evaluate how changes/updates affect benefit plan documents, ensuring compliance and accuracy
• Perform and coordinate primary drafting functions on ongoing standard filing projects, developing or revising contract language, applying annual updates, and directing team projects and special assignments assigned by management to ensure successful and timely completion
• Assist manager and leads in training and development of other team members, providing advanced support of all team functions while implementing process improvements to address inefficiencies and streamline operations
• Research and respond to objections from state regulators, resolving issues related to custom or standard filings, and coordinating efforts, when necessary, with Regulatory Affairs and/or the Legal Department

• Drafted custom member enrollment materials by translating data driven tools into, Booklets, Contracts and Summary of Benefit Changes documents
• Created and organized filing of regulatory documents with the insurance division
• Applied knowledge of State and Federal law and regulations and how changes/updates affect benefit documents
• Coordinated activities with all levels of staff within the plan and external agencies through clear and concise verbal and written communication skills, with the use of tactful and persuasive negotiation skills
• Analyzed insurance division objections, organized responses and resubmission functions.

Successfully completed Master of Business Administration (MBA) program with a focus on strategic management and finance, enhancing my business acumen and leadership skills

• Processed medical claims within required time limits, accurately applied contract benefits within guidelines and recognized incomplete or inappropriate claims
• Analyzed and investigated the disposition of a claim, which may have included payment, denial, or request for further review
• Researched and investigated problems related to delayed or denied claims in order to provide feedback to providers or members
• Contacted providers and members as needed for additional information, which required documenting actions taken
• Provided training to team members as well as staff from other departments in an effort to promote internal customer service.