Vernetha Caston
Edwards,MS
Summary
Human Resources Specialist with extensive experience in HR compliance and benefits administration at State of Mississippi Medicaid. Demonstrated success in enhancing onboarding processes and improving employee satisfaction through strong communication and analytical skills. Proficient in utilizing HR management systems to streamline operations and ensure regulatory compliance.
Overview
26
26
years of professional experience
Work History
Human Resources Specialist
State of Mississippi Medicaid
Jackson, MS
12.2022 - Current
- Established and generated reports to ensure HR compliance across all functions.
- Scheduled and conducted new employee orientations for seamless onboarding experiences.
- Developed and documented HR procedures to enhance process efficiency and policy adherence.
- Partnered with senior HR team to convey company standards and regulatory policies.
- Coordinated benefits administration activities, including enrollments, changes, and terminations.
- Maintained accurate employment records using human resources management system software.
- Managed applicant tracking system to uphold precise records of applicants and employees.
- Administered employee benefits programs, including health insurance and retirement plans, ensuring regulatory compliance.
Financial Counselor
University of Mississippi Medical Center, UMMC
Jackson, MS
09.2014 - 12.2022
- Negotiated payment arrangements with creditors when necessary, on behalf of clients.
- Provided ethical, objective and holistic financial planning advice to clients.
- Advocated for patients by contacting insurance carriers and obtaining necessary benefits information.
- Managed client expectations and resolved any concerns or issues promptly.
- Conducted comprehensive financial assessments with clients to identify their current financial situation and develop appropriate action plans.
- Analyzed wills, insurance policies, and corporate contracts for potential financial risks and opportunities for improvement.
- Developed and maintained strong client relationships through exceptional service and communication.
- Informed clients about tax benefits, government rebates, or other financial benefits to save patients money.
- Reviewed patients' accounts and plans regularly to determine the need for plan reassessment.
- Analyzed patients' insurance needs to recommend suitable life, health, and long-term care insurance products.
- Reviewed bank statements for accuracy and discrepancies with clients to ensure proper accounting practices were being followed.
- Recommended strategies for patients to help achieve financial goals.
- Liaised between physician, patient and insurance carrier to verify that each party had necessary information.
- Evaluated earnings performance to provide patients with in-depth ratings.
- Answered clients' questions regarding details of financial plans and strategies and explained data in easy-to-understand terms.
- Consulted with patients to assess and meet short- and long-term financial goals.
- Helped clientele gain access to available funding sources.
- Assisted patients without healthcare coverage to find resources, services and assistance needed.
- Educated patients on the importance of having an emergency fund in case of unexpected expenses.
- Followed up with patients regularly, and implemented consultative techniques to stay on top of financial means and objectives.
- Interviewed patients and families, answering questions regarding financial process during such sessions.
- Reviewed and verified financial data to determine program eligibility.
Benefits Specialist
State of Mississippi Department of finance & Admin
Jackson, MS
08.2007 - 09.2014
- Provided guidance on claims processing procedures to ensure timely payments.
- Coordinated benefits processing, including enrollments, terminations and claims.
- Provided assistance to plan participants by explaining benefits information to ensure educated selections.
- Mastered state and Federal benefit laws Including ERISA, FMLA, COBRA, HIPPA and 401k administration.
- Offered subject matter expertise on employment regulations, compensation policies and personnel management procedures to optimize internal structures.
- Processed benefit enrollment forms, changes, and terminations.
- Managed and maintained employee benefits programs including health insurance, retirement plans, and wellness programs.
- Stayed current with benefits trends and legislation through continuous education and professional development.
- Managed state employees' benefit and compensation programs for retirement, health, and life insurance.
- Ensured that employees are familiar with the benefits offered by the State of Mississippi Health Insurance plan.
- Assisted retirees with the enrollment process for the continuation of health insurance. Liaison for state employees and Blue Cross Blue Shield regarding provider insurance issues and resolutions.
- Informed employees about any changes to the benefit structure. Ensured the agencies' benefit and leave-of-absence policies comply with the law.
- Assisted state employees with the life insurance eligibility and verification process. Processed state life insurance death applications.
- Processed appeals based on State of MS Health Insurance guidelines. Educated the employees about their health insurance benefits.
Provider/Customer Service Representative
Blue Cross and Blue Shield of Mississippi
Flowood, MS
10.1999 - 07.2007
- Increased customer satisfaction ratings by effectively answering questions, suggesting effective solutions, and resolving issues quickly.
- Conferred with customers by telephone or in person to provide information about products or services and take orders.
- Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
- Resolved customer complaints in a timely manner.
- Followed company procedures for handling customer requests and complaints.
- Audited claims, verified insurance benefits, and made adjustments to erroneous claims. Discussed detailed health insurance benefits with state employees.
- Answered calls from the providers to discuss policy and procedures of the insurance benefits.
- Discussed proper ICD and procedure coding guidelines with providers.
- Researched and analyzed errors for corrected claims billing issues.
- Assisted state employees with continuation of coverage, life insurance, and retirees' premiums and benefits.
Education
Bachelor of Science - Business Administration
Jackson State University
Jackson, MS05-1991
Associate of Arts - Accounting
Hinds Community College
Raymond, MS08-1987
Skills
- Customer service
- Problem solving
- Benefits administration
- Excellent communication
- Human resources management systems
- HR compliance
- HR services
- Analytical skills
- Payroll completion
- MAGIC/EC experience
- SPAHRS
- DocuSign experience
- Smartsheet experience
Affiliations
- Finance Secretary for the Ministries
Timeline
Human Resources Specialist
State of Mississippi Medicaid
12.2022 - Current
Financial Counselor
University of Mississippi Medical Center, UMMC
09.2014 - 12.2022
Benefits Specialist
State of Mississippi Department of finance & Admin
08.2007 - 09.2014
Provider/Customer Service Representative
Blue Cross and Blue Shield of Mississippi
10.1999 - 07.2007
Bachelor of Science - Business Administration
Jackson State University
Associate of Arts - Accounting
Hinds Community College
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