Summary
Overview
Work History
Education
Skills
Websites
Skillsummary - Corecompetencies
Timeline
Generic

Wendy Carter

Newport News,VA

Summary

Seeking HR Administrator or Benefit Client Services Position (Onsite or Remote)

Overview

16
16
years of professional experience

Work History

HRCP OJT Program Coordinator , DBE/SWaM Compliance Specialist

HRCP
Norfolk, VA
11.2023 - Current
  • Recruit and screen candidates for the HRCP OJT Program VDOT
  • Provide initial, and follow-up interviews to document progress up to graduation
  • Work with managers throughout the hiring process
  • Review resumes for Craft positions appropriate to the Project
  • Direct focus on Women, Minorities and Displaced Individuals
  • Coordinate with HR, Payroll, Manager/Superintendent regarding hiring needs
  • Schedule HRCP OJT Candidate interviews of OJT Program
  • 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
  • Recruiting for Admin and Craft positions
  • Review resumes and schedule initial interviews
  • 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
  • Identifying Managers/Mentors in the work force to participate in the HRCP OJT Program
  • Review and develop HRCP 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 Civil Rights Representative
  • 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 Recuring/HR Department to coordinate hiring events and candidate selection
  • Offer support to Managers/Superintendents (Mentors) throughout the Program.
  • Reviewed and updated existing compliance policies and procedures.
  • Conducted periodic internal audits to ensure compliance with applicable regulations.
  • Developed and implemented training programs for employees on new or revised laws, regulations, and company policies.

Remote Benefits Advisor

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.

Remote Medicare Appeal Specialist

C2C Innovative Solutions, Inc
Jacksonville, FL
01.2023 - 08.2023
  • Maintain a current knowledge of C2C Medicare Second Level Appeals, policies, and procedures
  • Daily recording of VM messages to follow up on questions
  • 40 - 45 calls to Beneficiary/Provider daily to provide update of appeals
  • Maintains a current knowledge of CMS guidelines and regulations
  • Running monthly reports of appeals updates
  • Receives and perform research on appeals and categorizes each appeal appropriately
  • 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
  • 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.
  • Interpreted and analyzed complex legal documents to determine eligibility for appeals.
  • Reviewed appeal requests to ensure accuracy of information submitted.
  • Conducted research on medical records, financial data, and other relevant documents to support appeals.

Remote Telephonic Interviewer

Long Term Care Group, Inc
Eden Prairie, MN
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
Richmond, VA
09.2021 - 12.2021
  • Reviewed claims of a lower to a moderate level
  • Call Center Inbound and Outbound calls
  • Reviewed claims, identified the incident, 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 the
  • Deliver a high standard of service and empathy when following up with customers by letter, email, or telephone once the claim has been resolved.

Call Center Representative

Aerotek/Virginia Employment Commission
Newport News, VA
08.2020 - 03.2021
  • Provided efficient service to claimants calling to file a claim for Unemployment Benefits
  • Excellent people and communication skills
  • Prepared and collected information from claimants to obtain necessary information to process claims
  • Exceedingly passed 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.
  • Adhered strictly to all applicable laws and regulations pertaining to customer privacy rights.
  • Developed effective working relationships with team members across multiple departments.
  • Attended regular training sessions on updates and changes within the industry or organization.

Field Interviewer

NORC at the University of Chicago
Chicago, IL
11.2018 - 01.2019
  • Conducted in-person interviews fir 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
Hampton, VA
04.2017 - 03.2018
  • Elderly/Disabled population and liaison between residents and management
  • Conducted annual HUD assessments
  • Interviewed residents and had quarterly home f/u visits
  • Provided monthly case management services and crisis intervention
  • Advised management of issues and offered long term solutions
  • Monitored, Evaluated and Documented resident home and health condition
  • Prepared annual resident care plan and home visit
  • Complete and distribute reports to identified persons
  • Assisted in obtaining DME equipment such as wheelchair, Chair lift, Oxygen
  • Assisted in applying for Medicaid, Food Stamps, Medicare extra and LTC and Insurance
  • 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
  • Referred residents to recourses in the community such as social services, adult protective, mental health /substance abuse services, and employment services
  • 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 and evaluation annually
  • Knowledgeable of chronic diseases such as cardiovascular disease, diabetes, and obesity
  • Risk assessment/Interviewing skills and always maintained confidentiality.

Payroll Consultant

ADP
Norfolk, VA
08.2016 - 01.2017
  • Strong client relationship building skills
  • Call Center Inbound calls
  • Maintained time keeping records
  • Reviewed payroll and payroll reports for accuracy
  • Followed up in a timely manner
  • Excellent analytical and time management skills
  • Excellent communication skills - both verbal and written
  • Demonstrated critical thinking skills in the areas (HR, Payroll, and Benefit Administration.)

Client Service Analyst

Rangam Consultants Inc, Mercer
Dallas, TX
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

Willis Towers Watson, Extend Health
Richardson, TX
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.

Project Manager/Onboarding Specialist

Bank of America
Plano , TX
08.2012 - 06.2014
  • 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
  • Experience with rapidly and complex changing work environments
  • 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
  • Coordinated weekly meetings with Recruiting to set up new hire rehire onboarding
  • Supported the Global Technology Services and Associate Development Group
  • Enrolled new hires, transferred, and returning associate 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.
  • Conducted regular status meetings with internal teams and external partners to track progress against established milestones.
  • Analyzed data from various sources such as surveys, interviews, focus groups. to inform decision-making related to projects.
  • Presented findings from data analysis in a clear, concise manner that was easily understood by stakeholders at all levels of the organization.

Recuriting Coodinator/Contractor

Bank of America
Plano, TX
01.2012 - 08.2012
  • (Training and Development)
  • Managed multiple projects on the Associate Development Team
  • Coordinated with managers and stakeholders to identify role-based training requirements
  • Registered new hire training and requested system access in a in a virtual environment
  • Daily use of WebEx and SharePoint
  • Managed training roster for weekly virtual and classroom training
  • 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 and employees on HR issues.
  • Assisted in the preparation of construction contracts and agreements, ensuring accuracy and compliance with applicable laws.
  • Reviewed and interpreted blueprints, specifications, and other technical documents to ensure accurate project execution.
  • Developed detailed plans for projects based on customer needs and expectations.

Career Development Specialist

ResCare-Texas Workforce
Dallas, TX
01.2011 - 12.2011
  • Evaluated and interviewed candidates for WIA Workforce 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, and workshops
  • Attend hiring event and work with local Employment Services Government Agencies
  • Assisted students in enrolling in local schools for training and education
  • Coordinated with outside organizations regarding offering various courses and training programs
  • Sourced resumes and screened candidates via phone call and in person
  • Place job advertisement announcements or staff needs and open positions
  • Collaborated with displaced employees and clients receiving food stamps and Tanif benefits
  • Provided needs assessments and vocational evaluation
  • Met with local companies and set up hiring events for placing displaced workers
  • 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
Yorktown, VA
11.2008 - 09.2010
  • HR contact for PMO Office
  • Provided recruiting efforts for personnel stateside/overseas (Middle East)
  • Managed pre-employment process attended weekly meetings regarding background clarences
  • Coordinated appointments and start dates and supported human resources processes
  • Prepared new hire paperwork and ensured information is transferred too Corporate
  • Managed confidential information including departmental personnel files
  • Sourced, screened, interviewed candidates and met with managers
  • 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 timely
  • Drafted offer letter and send internal onboarding email
  • Maintained personnel records and confidential information
  • 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

Education

Master’s - Human Resources Management

Troy State
Troy, AL

Bachelor of Science - Counseling

Old Dominion University
Norfolk, VA

Skills

  • Excellent communication and interviewing skill
  • Dedicated and dependable (good work ethics)
  • Knowledgeable of Labor Laws and Payroll Practices
  • Screening, recruitment, and staffing experience
  • Attend hiring events and working with management
  • Selecting appropriate candidates for the OJT Program (VDOT)
  • Knowledgeable of home visit monitoring and crisis intervention
  • Experience in Benefit Administration: ACA, Medicaid, Medicare, Life, Health, Social Security Disability, STD, LTD, Worker’s Compensation
  • Group and Individual Insurance Health Plans
  • Ability to work with diverse social, ethnic, and diverse population
  • Case Management
  • Counseling
  • Coaching
  • Documentation Skills
  • Knowledgeable of Mental Health and Substance Abuse
  • Knowledgeable of Appeals and Claims Processing
  • Client follow-up via phone calls, emails text for Status Checks
  • Remote Inbound and Outbound Customer Service experience
  • Licensed Life and Health Insurance Agent
  • Texas Adjuster’s License
  • Resident License: VA (594679)
  • NPN: 3122236
  • Strong knowledge and experience using Salesforce
  • Excel
  • Microsoft Word
  • Outlook
  • Outlook Calendars
  • PowerPoint
  • SharePoint
  • Workday

Skillsummary - Corecompetencies

  • Excellent communication and interviewing skill
  • Dedicated and dependable (good work ethics)
  • Knowledgeable of Labor Laws and Payroll Practices
  • Screening, recruitment, and staffing experience
  • Attend hiring events and working with management
  • Selecting appropriate candidates for the OJT Program (VDOT)
  • Knowledgeable of home visit monitoring and crisis intervention
  • Experience in Benefit Administration: ACA, Medicaid, Medicare, Life, Health, Social Security Disability, STD, LTD, Worker’s Compensation
  • Group and Individual Insurance Health Plans
  • Ability to work with diverse social, ethnic, and diverse population
  • Case Management, Counseling, Coaching and Documentation Skills
  • Knowledgeable of Mental Health and Substance Abuse
  • Knowledgeable of Appeals and Claims Processing
  • Client follow-up via phone calls, emails text for Status Checks
  • Remote Inbound and Outbound Customer Service experience
  • Licensed Life and Health Insurance Agent, Texas Adjuster’s License
  • Resident License: VA (594679) NPN: 3122236: Expiration date: 10/31/2025
  • Microsoft office suites: Strong knowledge and experience using Salesforce, Excel, Microsoft Word, Outlook, Outlook Calendars, PowerPoint, SharePoint, Workday

Timeline

HRCP OJT Program Coordinator , DBE/SWaM Compliance Specialist

HRCP
11.2023 - Current

Remote Benefits Advisor

Sentara Health Plans, Medicare and IP/Insight Global
09.2023 - 12.2023

Remote Medicare Appeal Specialist

C2C Innovative Solutions, Inc
01.2023 - 08.2023

Remote Telephonic Interviewer

Long Term Care Group, Inc
02.2022 - 08.2022

Remote Travel Claims Examiner

Allianz Partners
09.2021 - 12.2021

Call Center Representative

Aerotek/Virginia Employment Commission
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 - 03.2018

Payroll Consultant

ADP
08.2016 - 01.2017

Client Service Analyst

Rangam Consultants Inc, Mercer
10.2015 - 07.2016

Application Data Processor

Willis Towers Watson, Extend Health
07.2015 - 10.2015

Project Manager/Onboarding Specialist

Bank of America
08.2012 - 06.2014

Recuriting Coodinator/Contractor

Bank of America
01.2012 - 08.2012

Career Development Specialist

ResCare-Texas Workforce
01.2011 - 12.2011

HR Generalist

DynCorp International
11.2008 - 09.2010

Master’s - Human Resources Management

Troy State

Bachelor of Science - Counseling

Old Dominion University

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Wendy Carter