Summary
Overview
Work History
Education
Skills
Timeline
Generic

Wiltonda Jones-Moore

Atlanta,GA

Summary

Detail-oriented Benefits Analyst with 10 years of experience doing meticulous and intensive work across multiple industries. Self-motivated Benefits Specialist demonstrating superior understanding of employee benefits laws and human resource software systems. Astute professional providing benefits support in fast-paced corporate settings.

Overview

11
11
years of professional experience

Work History

Benefits Analyst II

Cox Enterprises
04.2022 - Current
  • Determined eligibility and process benefit estimates, retirement calculations, and death benefits
  • Researched and responded to service-related inquiries
  • Reference pension plan provision sections regarding administrative issues
  • Demonstrate problem solving skills relating to the pension administration systems (Workday and/or Benefit Connect)
  • Provided outstanding customer service to plan participants, beneficiaries, and Employee Service Centers
  • Reviewed and entered demographic data, salary, job codes, retiree healthcare premiums, tax withholdings, banking information, and beneficiary options
  • Requested payroll modifications and adjustments for replacements and/or required minimum distribution
  • Validated and initiated overpayment recovery
  • Processed Social Security recalculations
  • Provided inbound/outbound call handling support as needed
  • Assisted with identifying reporting and query needs
  • Accurately updated and maintained electronic records
  • Answered general 401(k) administration questions
  • Inbound and outbound call handling on Cox Corporate Benefit Helpline
  • Processed Tier 1 retirement transactions (EFT, tax withholding, benefit verification and demographic changes that were received either by fax, mail, or email
  • Assisted retirees with Cox Pension Connect retirement portal to register user account
  • Processed returned mail
  • Communicate eligibility of pension benefits, final calculations of benefits, health, and death benefits
  • Demonstrate problem solving skills relating to the pension administration systems (Workday and/or Benefit Connect)
  • Researched and responded to service-related inquiries
  • Provided system support for plan participants with online enrollment, application of benefits, intermediate and complex technical issues
  • Pension Plus and Pension Connect Integration.

Accounts Receivable / Cash Applications-Billing Specialist

Cox Enterprises/Atlanta Journal Constitution
01.2018 - 04.2022
  • Maintain collection notes in financial system
  • Revise and re-issue invoices
  • Process vendor Checks, ACH, and credit card payments
  • Monitor monthly activities and manage vendor invoicing
  • Perform a variety of basic accounting tasks in accordance with standard procedures, including general accounting tasks
  • Interfaced and maintained positive relationships with all clients, vendors and associate personnel
  • Reconcile the accounts receivable ledger to ensure that all payments are accounted for and properly posted
  • Process accounts and incoming payments in compliance with financial policies and procedures
  • Applied refund and account adjustments to newspaper home delivery and single copy customers
  • Researched payments that were posted and applied to incorrect customer accounts
  • Balanced accounts, grace balance and write offs for accounts that were 90 + days past due
  • Scanned and franked checks received and applied monies to varies accounts
  • Balanced account receivables, AR reports and bank General Ledger reporting
  • Generated invoices and rebills for Single copy customer accounts
  • Accepted ACH and Credit Card batches to post and apply to various home delivery customer and business and Single Copy accounts
  • Generated weekly and monthly billing and revenue cycle reports for the Atlanta Journal and Delta Airlines various accounts
  • Manually created invoice for current accounts and accounts that were in 90-120 days past due
  • Called customers that had past due balances to make payment on accounts prior to sending to collections
  • Set up payment arrangements for customers on past due account Manager bad debit analysis repo
  • Monitor banking systems for wires and ACH payments to apply to customer accounts
  • AJC Billing for Carrier payments
  • Manual billed WDFG and Delta Global invoicing for payments
  • Lockbox Web exceptions
  • USBank previous day and lockbox reporting
  • Account and credit adjustments for Newspaper shrink write offs
  • Balanced accounts receivable cash log daily
  • Managed collections and key accounts including but not limited to, Delta, WDFG, Areas, Terry Cullen, Circle K etc
  • Researched discrepancies for the issuance of credits when warranted for pricing and shortage for returns
  • Increases AR collections by successfully and consistently managing key accounts
  • Handles back-end functions including quality processing controls & balancing of deposits
  • Researching customer accounts to identify and verify proper account for posting payments
  • Prepares client payments for processing
  • 10 key data entry of account number, invoice numbers, amounts, etc
  • Performs research and adjustment activities
  • Balanced credits and debits within transactions
  • Processing exceptions - researching customer payment issues and correcting out-of-balance conditions
  • Other related duties assigned as needed.

Tier II Customer Service Supervisor

Cox Media Group
07.2016 - 01.2018
  • Handled escalated calls regarding customer subscription and delivery issues
  • Processed payments for AJC newspaper subscriptions
  • Responded to digital support calls from customers having issues viewing their digital electronic newspaper online
  • Processed and responded to customer email inquiries regarding billing and making payments, delivery issues and new subscriptions via SharePoint portal
  • Assisted new customers with account set up, current rates and payment options
  • Started new home delivery subscriptions for new and existing customers
  • Provided troubleshoot support for customers that had firewall and popup block issues with downloading digital E-paper.

Provider/Member Service Rep Peach State Health Plans Ambetter

Centene Corp
07.2015 - 05.2016
  • Provided members with co-pay, deductible, and premium information for each plan type
  • Explained EOB with members regarding out-of-pocket expenses
  • Reviewed claims that were denied in CRM for non-par provider participation, member eligibility
  • Added or changed member demographics and PCP look up search
  • Processed member premium payments and generated invoice receipt using Emdeon
  • Provide service excellence during every patient encounter or when providing internal customer service
  • Answered member/provider request or inquiries concerning premium payments, eligibility and claims processing
  • Answered billing inquiries, investigated payments that had not been posted to accounts causing premium terminations, quoted amount due for pre-member premium payments
  • Adhere to established policy and procedure, produced quality standards and metrics for monthly and quarterly work performance
  • Coordinate work requests or queued billed inquiries with appropriate departments, informing members of the actions taken
  • Investigate and Que billing and canceled policy information
  • Escalated premium discrepancy to Health Insurance Marketplace
  • Assisted members with Marketplace Exchange and healthcare.gov portal for enrollment questions.

Medicare Part B Claims/Provider Enrollment Rep

Anthem (NGS)
07.2013 - 07.2015
  • Assisted providers with the CMS Medicare enrollment applications
  • Aided with the NPPES registry for providers to change practice location information
  • Reviewed enrollment applications that were rejected for nonresponse to development documentation
  • Received and reviewed reconsideration request for providers that we barred or termed from Medicare
  • Provided revalidation extensions creating Share Points
  • Updated provider enrollment records to add or remove holds for nonpayment, DNF on suspended status
  • Provided customer service to Part B Medicare providers via telephone, fax or through email
  • Discussed claim denials with providers, to assist them with billing /coding errors on their CMS-1500form
  • Reprocessed W-Status claims that were rejected due to contractor or processor errors
  • Knowledge of Third-Party payers, billing requirements, and reimbursement methods
  • Verified Medicare Beneficiary Part A/B, Medicare Advantage Plan, Workers- Comp, Working Age and any other supplemental plans that they may have
  • Assisted providers with appeal processing including timely filing limits and ADR letters that were requesting more documentation
  • Claims that were selected for Medical Review CCR would provide what was required and provided address and phone number to resubmit documentation
  • Provided coding assistance on claims that were denied due to NCCI edits, assisting with how to modify claims using the correct modifier or units in order unbundle and rebill claim for payments
  • Update, add or change Medicare Beneficiary demographic information on web portal
  • Assist providers with their revalidation including CMS- 855I, CMS 855B, CMS 855O, Medicare 460 and 588 EFT financial forms
  • Knowledge of medical terminology
  • Adhere to established policy and procedure, produced quality standards and metrics for monthly and quarterly work performance.

Mail Clerk

BNY Mellon
01.2013 - 07.2013
  • Sorted, prepped, and scanned incoming mail and other financial documents
  • Keyed data entered return checks into data log system for check report
  • Scanned backend billing reports for processing preparing documents for the Benefit Disbursement Rep (Call Center Rep) promoted to this position 2/05/13
  • Customer Service representative assisting clients with making changes to their retirement benefits accounts
  • Mailed, faxed, or emailed change request forms to retirees to update address change, direct deposit EFT
  • Information
  • Received inbound calls from banks regarding retirement payments.

Education

Database Specialist (AAS) -

Southern Crescent Technical College Griffin

Skills

  • Employee Benefits Laws
  • Proficient in Workday, Microsoft , ADP, Oracle, CRM
  • Benefits Explanation
  • New Employee Enrollment
  • Benefits Administration
  • Verbal and Written Communication
  • Documentation and Reporting
  • Employee Relations

Timeline

Benefits Analyst II

Cox Enterprises
04.2022 - Current

Accounts Receivable / Cash Applications-Billing Specialist

Cox Enterprises/Atlanta Journal Constitution
01.2018 - 04.2022

Tier II Customer Service Supervisor

Cox Media Group
07.2016 - 01.2018

Provider/Member Service Rep Peach State Health Plans Ambetter

Centene Corp
07.2015 - 05.2016

Medicare Part B Claims/Provider Enrollment Rep

Anthem (NGS)
07.2013 - 07.2015

Mail Clerk

BNY Mellon
01.2013 - 07.2013

Database Specialist (AAS) -

Southern Crescent Technical College Griffin

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Wiltonda Jones-Moore