Wendy Wahl

• On-site point person for problem-solving in customer relations.
• Policy review and customer inquiries are essential. Relations with insurance companies by underwriters also play a crucial role.
• Maintained accuracy in processing payments
• Informed customer about available programs to help reduce insurance premiums.
• Utilized problem-solving skills when dealing with difficult customers.
• Coordinated with internal teams to ensure timely delivery of products and services to clients.
• Resolved customer complaints in a timely manner.

Eligibility and Enrollment

New business enrollment for Medicare and non Medicare lines of business.

• Collected requirements, conducted analysis, and converted business needs into precise specifications.
• Project work on Medicare Supplemental eligibility.
• Facilitated coordination meetings with cross-functional teams to determine the root cause of production issues.
• Daily triage of ServiceNow tickets.
• The Covid Pandemic created a necessity for one parent to ensure stability for our children's future, while the other covers the cost of living.

• Primary Analyst to priority account.
• Responsible for the ultimate success and integrity of client EDI feeds.
• As the Project Lead, I facilitated daily meetings with cross-functional internal teams, maintained up-to-date documentation, resolved subsequent issues or inquiries, and delivered regular updates to stakeholders.
• Conducted interviews with stakeholders to gain an understanding of their business objectives and user needs.
• Analyzed business needs and translated them into system requirements.
• Performed functional testing of software applications during development cycles.
• Drafted detailed (BRD) business requirements, technical specifications and mapping documents.

• Utilized Facets NetworX for facility configuration. rate sheet creation and distribution to operations
• Analyzed First Pass Error pending and provided soulution for First Pass Gain.
• Tested procedure and code in a SCRUM environment while translating business policy methods to a system developers.
• Mastered TFS tracking for SCRUM agile environment.

• Prepared policy documents concerning benefit offerings and relayed updates to the management teams.
• Analyzed employee benefit plans and recommended changes to ensure cost-effectiveness.
• Organized periodic meetings with department heads to discuss changes required in existing benefit offerings.
• Lead Analyst representing operations on weekly calls for standard non-standard requests on product.
• Investigated potential issues with employee claims or discrepancies with premiums paid versus coverage received.
• Worked closely with vendors, Sales, and Implementation Coordinator to ensure timely implementation of renewal and new benefits programs.
• Project lead for January 1, 2012 Integration release (Electronic Data Interchange) Transition from ANSI X12 version 4010 to 5010 Exchange.
• Trained an offshore team of eight persons to audit EDI files specifically all STC (Service type code) transactions for new and renewal group implementation. Handled new product development across six platforms.
• Joined the Benefits team with 7 years claims experience with Anthem.