Wendy Carter
Newport News,VA
Summary
Seeking Administrative or Case Management Remote or In person Position
Overview
18
18
years of professional experience
Work History
OJT Program Coordinator, Admin for DBE/Swam Program (VDOT)
HRCP (HRBT Tunnel Expansion Program)
11.2023 - Current
- Recruit and screen candidates for the HRCP OJT Program (VDOT)
- Interview candidates for craft position to participate in the OJT Program
- follow candidates throughout the OJT Program until graduation
- Work with managers throughout the hiring process
- Schedule interviews with managers and VDOT Consultant
- Review resumes for Craft and Field Clerk/Administrative positions appropriate to the HRBT Project
- Maintain Monthly Event Calendar
- Coordinate with HR, Payroll, Manager/Superintendent regarding hiring needs
- Work closely with VDOT, FHWA to follow the regulations and guidelines of the Program
- Educate Managers and other department staff to find candidates for the Program
- Attend local hiring events in Hampton and the Southside
- Review resumes and schedule interviews with Managers
- Sourced resumes and screened candidates via phone call and in person
- Review the current workforce needs to find individuals suitable for the program
- Identifying current HRCP workforce to assist in upscaling and upskilling employees
- Place job advertisement announcements or staff needs and open positions
- Review and find appropriate OJT Program curriculum to enhance skills and certifications
- Knowledgeable of Community Resources such as VEC, Community Colleges and Universities and Trade Schools
- Collect and track weekly timecards to submit to VDOT Consultant
- Attend hiring event and work with local Employment Services Government Agencies
- Report pay increase to payroll to update pay increase due to training milestones in the program
- Work with HRCP Recurring/HR Department to coordinate hiring events and candidate selection
- Offer support to Managers/Superintendents (Mentors) throughout the Program.
Remote Benefits Advisor (Temp position AEP/ACA)
Sentara Health Plans-Medicare and IP/Insight Global
09.2023 - 12.2023
- Background in Medicare, Medicaid and/or individual plans (IP)
- Excellent Interviewing skills
- Explained the benefits and features of Health and ancillary products
- Enrolled individuals into Health plans that meet their needs
- Followed Medicare Enrollment guidelines and requirements
- Answered questions regarding Medicare/Medicaid Insurance
- Services applicants with Medicare and Medicaid members
- Knowledge of community resources
- Possessed Active Health Insurance License: VA, TX, SC, FL
- Knowledgeable of Community Resources
- Strong communication skills and the ability to communicate well with clients at all levels
- Strong time management and organizational skills and Inbound and Outbound calls
- Explain/articulate complex insurance programs to callers in ways that are clear and concise
- Ability to navigate multiple systems at one time while talking on the phone
- Updated Beneficiaries demographic information and documented each call.
Remote Medicare Appeal Specialist
C2C Innovative Solutions, Inc.
01.2022 - 08.2023
- Maintains a current knowledge of C2C Medicare Second Level Appeals, policies, and procedures
- Familiar with CMS MAS System to update information for appeals
- Daily recording of VM messages to follow up on inquiries
- Assisting Providers on submitting appeals via C2C Website
- Daily calls 30-40 calls to Beneficiary/Medical Providers providing updates/inquiries on appeals
- Maintains a current knowledge of CMS guidelines and regulations
- Performs research and provides guidance on guidelines and procedures
- Corresponds with the member as required (i.e., written acknowledgement and closure letters and telephone contact and documentation as appropriate)
- Communicates with providers in a professional manner, and clearly articulates what information is required for processing of appeals
- Respond to correspondence and review documents
- Contribute to individual, team and department goals
- Completes data entry and documentation requirements in multiple systems, including correct input of audit universe fields
- Upload correspondence to cases and provide follow letters response to incoming mail
- Interacts with Medical Providers, Billing Specialist, Managers, Medical Directors, Case Management, Precertification, Legal, Member Services and other areas in facilitating identification and resolution of appeals
- Responsible for meeting all regulatory and department timelines.
Remote Telephonic Interviewer
Long Term Care Group, Inc.
02.2022 - 08.2022
- Scheduled and conducted telephonic interviews for insurance company
- Conducted Lincoln (health assessment) application and Cognitive Screenings
- Completed telephone interviews with Long Term Care applicants with a pre-determined script
- Collected concise and accurate information/documentation on client’s health history
- Accurately Collect Applicants data and medical history and lifestyle information
- Tactfully redirect applicants when needed in order obtain required information
- Completed all interviews in a timely manner, according to department guidelines
- Made Outbound Calls to Schedule Applicants Interview Appointment
- Good understanding of Medical Terminology.
Remote Travel Claims Examiner
Allianz Partners
09.2021 - 12.2021
- Reviewed claims of a lower to a moderate level
- Call Center Inbound and Outbound calls
- Reviewed claims, identified incidents, determined coverage in accordance with the contract
- Reviewed documentation to determine if the loss is covered and what benefits apply
- Determined reimbursed based on terms and conditions of the insuring agreement
- Responsible for paying or rejecting the claim
- Follow-up with customers either by letter, email, or telephone and chat
- Answer incoming calls or email inquiries from customers regarding the status of their claim
- Researched discrepancies and verified or obtained missing information
- Updated Claimant demographic information and documented each call
- Responsible for paying or rejecting claims in accordance with policy guidelines
- Contribute to individual, team and department goals
- Deliver a high standard of service and empathy when following up with customers by letter, email, or telephone once the claim has been resolved.
Remote Call Center Representative
Aerotek/Virginia Employment Commission (Temporary)
08.2020 - 03.2021
- Provided efficient service to claimants calling to file a claim for Unemployment Benefits
- Prepared collected information from claimants to obtain information to process claims
- Exceedingly pass random test calls showing empathy and focus on the needs of customers
- Maintained sincere interest in providing stellar customer care
- Updated Claimant demographic information and documented each call
- Knowledgeable of products, good work ethic and effective time management skills
- Call Center Environment.
Field Interviewer
NORC at the University of Chicago
11.2018 - 01.2019
- Conducted in-person interviews
- Pre-selected households
- Provided basic Interviewing Techniques
- Required to update the case management system with all contact and attempts
- Transmitted information workday
- Participated in a weekly telephone call with FM to discuss the status of each case
- Prepared plan for each week’s deliverable
- Documented all activities in the case management system in a professional manner
- Contacted respondents of assigned cases to determine the status and location of each case
- Weekly review process on each project cost and production goals
- Data quality review and met expected quality targets.
Resident Service Coordinator
Paula Maria Village (The Capital Realty Group)
04.2017 - 01.2018
- Elderly/Disabled population and liaison between residents and management
- Conducted annual HUD assessments
- Excellent Interviewer skills and crisis counseling
- Met with new residents for annual review of health assessment
- Advise management of issues and offer long term solutions
- Complete and distribute reports to identified persons
- Other duties and responsibilities as assigned
- Coordinated with Social Services Long Term Care Medicaid evaluation for Benefits
- Referred to Adult Protective Services for evaluation
- Coordinated monthly programs such as Food Bank
- Prepared monthly case management report required by HUD
- Proficiency in MS Office Suite and the ability to learn new databases (AASC Online)
- Assisted residents to obtain RX and set up mail orders
- Documented Clients Status and Progress
- Referred residents to local resources in the community as needed
- Knowledgeable of chronic diseases such as cardiovascular disease, diabetes, and obesity
- Risk assessment/Interviewing skills and always maintained confidentiality.
Payroll Consultant
ADP
08.2016 - 01.2017
- Manage payroll preparation
- Experience with ADP payroll software and systems
- Strong client relationship building skills
- Assist clients with payroll processing
- Solve any payroll issue or concerns that may arise
- Call Center Inbound calls
- Demonstrated critical thinking skills in the areas (HR, Payroll, and Benefit Administration.)
- Followed up in a timely manner
- Good knowledge of industry tools
- Excellent analytical and time management skills
- Excellent communication skills - both verbal and written.
Client Service Analyst
Rangam Consultants Inc-Mercer
10.2015 - 07.2016
- Monitored project to ensure timelines and deliverables
- Call Center Inbound and Outbound calls
- Managed benefits administration for clients and processed death claims (MetLife)
- Updated SOP for benefit policy updates changes for call center agent inquiries
- Worked with Supervisors and Team Leads in the call center on escalated issues
- Processed benefit enrollment to ensure properly completed and processed
- Maintained benefit records communicated with carriers regarding changes and updates
- Meet with LOB, Project Manager, TL, client to define project scope and objectives
- Prepared work plans, documenting project's scope, and review with clients Requirements
- Provided coaching and problem solving to managers and employees
- Call Center environment
- Provided monthly and quarterly reports
- Acted as a liaison between field operations, managers, employees, provided HR support.
Application Data Processor (Seasonal)
Willis Towers Watson - Extend Health
07.2015 - 10.2015
- Provided aid to Medicare Beneficiaries in a call center environment
- Call Center Inbound and Outbound calls
- Facilitated application data collection from participants in a timely and accurate manner
- Collected data to complete enrollment application and process payment
- Resolved escalated issues in a timely manner to promote customer satisfaction
- Ability to read, analyze and interpret documents such as detailed correspondence, procedure manuals, and insurance application
- Extensive HIPAA Compliance Training.
Remote Project Manager – Onboarding (Training and Development)
Bank of America
08.2012 - 06.2014
- Managed multiple projects on the Associate Development Team
- Coordinated with managers, team leads to identify role-based training requirements
- Registered new hire training and requested system access in a virtual environment
- Managed training roster for weekly virtual and classroom training
- Coordinated with staffing/recruiting to review steps for onboarding new hires/rehires
- Guided students the onboarding process checking attendance/completion of courses work
- Sent out weekly welcome email and training agenda for updating week
- Follow up with students throughout completion of training and adjusted as needed
- Tracked and reported the effectiveness of training on employees to management
- Scheduled meetings and reserved courses in classroom and online
- Created teaching aids, PowerPoint presentations, and reference for various training
- Answered employee and manager questions/concerns enrollment into training
- Provided counseling, coaching and problem solving to managers/employees on training issues
- Assisted Sr
- Project Manager with team projects, SharePoint site and weekly team meeting
- Managed project resources, project plans and timelines to ensure deliverables are met
- Daily use of WebEx and SharePoint and updated Team documents on SharePoint Site
- Excellent project management skills and work in a virtual environment.
Benefits Advisor (Seasonal)
Willis Towers Watson - Extend Health
08.2013 - 12.2013
- Residential Life/Health Insurance licensed in multiple states
- Built and maintained effective relationships with beneficiaries and customers
- Responding to beneficiary’s inquiries and properly document service issues
- Interpreted and applied varying guidelines across multiple insurance carriers
- Worked effectively as a team player to ensure a professional work environment
- Call Center environment
- Provided HIPAA Compliance Training.
Recruiting Coordinator
Randstad- Bank of America (Contractor)
01.2012 - 08.2012
- Responsible for overseeing on-boarding activities for Home Loan Fulfillment associates
- Interacted with Recruiter, Recruiting Coordinators, Technology Partners, Managers/ BSMs
- Managed on-boarding of new hires, transfers and returning associates and served as the liaison between the market and business partners to support the on-boarding process
- Responsible for the Central, East and West Region
- Proactively communicated to managers and employees about programs and initiatives
- Provided training and support to associate level HR staff
- Coordinated with Start Team all pre-day one technology orders and selected systems access
- Supported the Global Technology Services and Associate Development Group
- Enrolled new hires, transferred, and returning associates in training courses
- Requested system access in a in a virtual environment
- Tracked training participation and rescheduled courses when necessary
- Responsible for answering questions regarding new hire training
- Processed employees returning from LOA, transfers, and termination
- Effectively documented case notes in a case management system in a clear and concise manner.
Career Development Specialist
ResCare-Texas Workforce
01.2011 - 12.2011
- Evaluated customer for the WIA Program
- Screened, interviewed applicants to identify barriers
- Counseled individuals to help them understand and overcome personal, social, or behavioral problems affecting their educational or vocational situations
- Evaluated students’ career interests and personality characteristics using tests
- Researched information for curriculum development, training programs, classes/workshops
- Assisted students in enrolling in local schools for training and education
- Coordinated with outside organizations regarding offering various courses/training programs
- Worked with displaced employees and clients receiving food stamps and Tanif benefits
- Provided needs assessments and vocational evaluation
- Provided employment preparation and training
- Interviewed and gathered information on training needs, educational background, work experience and skills and interest to develop an employment plan
- Monitored grades/attendance to ensure students were maintaining academic satisfactory progress.
HR Generalist
DynCorp International
11.2008 - 09.2010
- HR contact for PMO Office
- Provided recruiting efforts for personnel stateside/overseas (Middle East)
- Managed the pre-employment process by running background checks
- Prepared new hire paperwork and ensured information is transferred too Corporate
- Handled confidential information including departmental personnel files
- Sourced, screened, interviewed candidates
- Performed reference-checking procedures on candidates to confirm past performance
- Coordinated personnel actions such as FMLA, benefits, union issues and compliance
- Used PeopleSoft to process new hires, rehire and transfer onboarding paperwork
- Coordinated, scheduled, and confirmed interviews (phone & in-person) with candidates
- Monitored drug test process to make sure candidate completes drug test within time frame
- Drafted offer letter and send internal onboarding email
- Set up travel arrangements for international and domestic travel
- Distributed candidates interview schedules, interview forms, and resumes to HR and Hiring Managers for face-face and phone interviews
- Posted job descriptions to external job boards and company websites
- Updated personnel transactions in web-based HR/Payroll HRIS system (PeopleSoft).
HR Generalist
Norfolk CSB
03.2008 - 09.2008
- Responsible for human resources and maintained personnel transactions in (PeopleSoft)
- Screened and conducted face to face and phone interviews, testing, and job fairs
- Entered employee personnel data in HRIS System and updated employee file when needed
- Maintained spreadsheets regarding personnel and prepared weekly and monthly audits
- Tracked credentialing of licensed professional staff such as nurses, psychologist, physicians, SA counselors, recreational therapist, Counselors, and social workers
- Send renewal notification email or letters to practitioners in need of recertification
- Monthly monitoring of the Health and Human Services Gov Website of updated licensures
- Assisted HR Manager with Mid-Year and Annual Performance Management reviews
- Provided presentation for new hire orientation, education sessions and open enrollment
- Knowledge of compliance with related federal and state laws
- Processed status changes, promotions, merit increases, terminations, data changes
- Reviewed payroll for updates and errors, and reviewed, and interpreted SPDs
- Ensured medical staff maintained required current licensures and certifications
- Responsible for benefit administration including claims and self-funded benefit experience
- Administered Health and Wellness Benefits, ST/LT Disability, COBRA, and Workers Comp
- Cobra Administration, employee, and dependent notification
- Administer the STD/LTD Disability and Leave Program with timely resolution of issues
- Assisted employees with Medical, Dental, FSA, and Disability claims and payment inquiries
- Processed semi-monthly payroll exceptions including merit and salary increases
- Conducted exit interviews and provided feedback to the HR Manager with recommendations.
Sr. Benefits Specialist
EDI
04.2006 - 04.2007
- Provided telephone support for Washington Mutual Benefits Center
- Responsible for the administration of H&W Benefits and retirement plans for 60,000 employees
- Resolved complex claim issues; handled escalated supervisor calls
- Call Center Inbound calls
- Acting evening supervisor for 5 customer service representatives
- Responded to email inquiries
- Managed feedback report, and enrollment statistics
- Interpreted policies and regulations to employees and management
- Coordinated new hire orientation and annual open enrollment
- Answered new hire questions and assisted them in benefit elections
- Participated in the appeals committee and prepared appeal determination letters
- Project Management skills and generated monthly reports
- Educated and guided new hires on an online new hire/benefits enrollment Website.
Education
Master of Science -
Troy State University
Troy State University12.2001
Bachelor of Science - Counseling
Old Dominion University
Norfolk, VA05.1988
Skills
- Eligibility Determination
- Case Management/Mental Health/SA
- Recruiting
- Hiring and recruitment knowledge
- Project Management
- Project Coordination
- Office Administration
- Needs analysis
- Training Coordination
- Interpersonal Skills
- Understanding of human resources
- Excellent Communication
- Customer service experience
- Problem-solving aptitude
- Problem-solving abilities
- Benefit Administration
- Group and Individual Insurance Health Plans
- Government Insurance, Medicaid, Medicare, Social Security
- Licensed Life and Health Insurance Agent- VA- (3122236)
Skill Summary
Excellent listening and interviewer skills, Insurance and Benefit Administration Experience, Ability to work with diverse social, ethnic, and diverse population, ACA, PeopleSoft, ADP, Workday, SharePoint, Webex, Costpoint and SAP, Group and Individual Insurance Health Plans, Social Security Disability, Experience with Government Benefits such as Medicare/Medicaid., Experience servicing clients/Individual and Group Health Plans, Superb analytical, organizational, and problem-solving skills, Knowledgeable of employee personnel policies and procedures, Accurately monitor and documents client’s progress, Knowledgeable of HR Polices and Benefit Administration, Case Management, Counseling, Coaching and Documentation Skills, Dedicated and dependable (good work ethics), Skilled at developing an approving process, Excellent in communicating by phone, video conferencing, Licensed Life and Health Insurance Agent, Texas Adjuster’s License, Communication experience with inbound and outbound calls, texts and emails, Microsoft office suites: knowledgeable using Excel, Microsoft Word, Outlook, Outlook Calendars, PowerPoint, SharePoint, Workday, Troy State, Troy, AL, Master’s Human Resources Management, Old Dominion University, Norfolk, VA, Bachelor of Science in Counseling, https://www.linkedin.com/in/wendy-c-23222328/
Timeline
OJT Program Coordinator, Admin for DBE/Swam Program (VDOT)
HRCP (HRBT Tunnel Expansion Program)
11.2023 - Current
Remote Benefits Advisor (Temp position AEP/ACA)
Sentara Health Plans-Medicare and IP/Insight Global
09.2023 - 12.2023
Remote Telephonic Interviewer
Long Term Care Group, Inc.
02.2022 - 08.2022
Remote Medicare Appeal Specialist
C2C Innovative Solutions, Inc.
01.2022 - 08.2023
Remote Travel Claims Examiner
Allianz Partners
09.2021 - 12.2021
Remote Call Center Representative
Aerotek/Virginia Employment Commission (Temporary)
08.2020 - 03.2021
Field Interviewer
NORC at the University of Chicago
11.2018 - 01.2019
Resident Service Coordinator
Paula Maria Village (The Capital Realty Group)
04.2017 - 01.2018
Payroll Consultant
ADP
08.2016 - 01.2017
Client Service Analyst
Rangam Consultants Inc-Mercer
10.2015 - 07.2016
Application Data Processor (Seasonal)
Willis Towers Watson - Extend Health
07.2015 - 10.2015
Benefits Advisor (Seasonal)
Willis Towers Watson - Extend Health
08.2013 - 12.2013
Remote Project Manager – Onboarding (Training and Development)
Bank of America
08.2012 - 06.2014
Recruiting Coordinator
Randstad- Bank of America (Contractor)
01.2012 - 08.2012
Career Development Specialist
ResCare-Texas Workforce
01.2011 - 12.2011
HR Generalist
DynCorp International
11.2008 - 09.2010
HR Generalist
Norfolk CSB
03.2008 - 09.2008
Sr. Benefits Specialist
EDI
04.2006 - 04.2007
Master of Science -
Troy State University
Bachelor of Science - Counseling
Old Dominion University
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