Lore D. Graham

**** ******* ****

Delaware, Ohio 43015

614-***-****

ace0o5@r.postjobfree.com

Qualification Profile

. Highly accomplished, results oriented Employee Benefits Manager and

Insurance Sales and Service Account Manager with extensive experience in

sales, service, account retention, planning, implementation and

administration of cost effective and competitive health and welfare

benefit programs.

. Proficient in employee benefits plan design and analysis, bid

preparation, request

for proposal evaluation, program implementation, contract

negotiation, contract

performance and compliance.

. Wide knowledge of state and federal laws of the employee benefits

program.

. Proven success in exceeding sales goals, and vendor and client

relationship

through high client retention and satisfaction levels.

. Flexible team player and proven achiever with a strong work ethic and

drive to

succeed.

. Extremely motivated to excel and contribute to the success of any

organization.

Core Competencies

. Strategic and Consultative Sales . Account Management . Project

Management .

. Operations Management . Benefit Plan Design . Funding Arrangements .

. Negotiation . Account Reporting . Benefit Communications . Operations

and

. Claims Audits .Employee Benefits Enrollment Process and Reconciliation .

Claims Appeals . Customer Service . Regulatory and Compliance

. ERISA, COBRA, HIPPA, FSA and ACA .Word, Excel, PowerPoint, Outlook and

PeopleSoft

Senior Account Representative

Anthem (2013 - present)

. Serve as primary client contact and liaison between client and internal

departments.

. Ensure new benefits programs sold are implemented and administered

properly.

. Manage wellness programs and coordinate health fairs.

. Coordinate annual open enrollment.

. Demonstrate walk-through of client, broker and member portals.

. Resolution of escalated claims, membership and system access issues.

. Request, review and deliver various claims, membership and billing

reports.

. Reconcile employee enrollment and benefits selections.

Benefits Manager

State of Ohio (2004 - 2013)

. Served as third party vendor liaison for health and welfare plans.

. Administered COBRA, dental, vision, life, FSA and long-term care.

. Managed a Benefits Analyst with direct report responsibility.

. Prepared bid specifications and led request for proposal and vendor

evaluation in

collaboration with benefits consulting firm and procurement

personnel.

. Coordinated, monitored and evaluated contractor performance of employee

benefits programs.

. Established rate setting.

. Negotiated benefit program renewal.

. Ensured all benefit plans, policies and programs were in compliance with

federal

and state legislation.

. Created benefits communication materials.

. Reviewed periodic data for program design improvements and vendor

contract

compliance.

. Prepared reports cost and benefit analysis.

. Generated vendor billing invoices under a self-bill arrangement.

. Managed daily administrative duties including medical premium payments,

appeals, exempt employee life insurance claims certification and problem

resolution.

. Investigated legal and legislative actions which may impact the plan;

update

contract language as appropriate.

. Trained agency benefits specialist on PeopleSoft HCM module.

Insurance Agent

Secure Choices (1999-2004)

. Acquired new business revenue and increased existing business revenue

through

quotes, leads and referrals.

. Exceeded revenue targets by maintaining existing business and increasing

volume

by 30%.

. Actively managed accounts including resolving elevated claim and premium

payment issues.

Key Account Manager

United Healthcare of Ohio (1996-1998)

. Handled all aspects of self-insured and fully-funded employer group

health account

management successfully.

. Increased retention by meeting client requests in a timely and accurate

manner, thus securing repeat business.

. Successfully negotiated renewal sales with company officials resulting

in 97% retention of major accounts.

Medicare Sales Representative

. Demonstrated expertise in securing substantial enrollment in both

individual and

group markets.

. Coordinated and conducted public meetings for Medicare eligible

individuals and

training sessions for employer group retirees.

. Recognized as top sales representative in the state, averaging 135

individual

monthly sales with a 97% retention level in the first 12 months of

operation.

. Exceeded personal and team new business goals by 20%.

Account Executive

Health First (1995-1996)

. Sold and serviced employer group HMO, life, AD&D, prescription drug,

vision and

dental products.

. Increased product visibility and market share through presentation and

development of four major accounts increasing revenue by 20%.

. Credited with achievements servicing existing accounts to ensure

renewals and

maximize profit potential through sales of ancillary products.

. Demonstrated expertise in new business development, client needs

analysis,

product presentation, suggestive/strategic selling and problem-

solving.

Major Account Executive

Medical Mutual of Ohio (1986 - 1995)

. Managed State of Ohio self-funded medical PPO plan and life plans for

62,000

employees.

. Acted as consultant to employer on plan design and cost for union-

negotiated

health benefits.

. Implemented benefits internally to ensure proper claims adjudication,

monitored

internal performance requirement for contract compliance.

. Worked directly with underwriter to establish rates.

. Recipient of President's Cabinet Award for outstanding service.

Education

. Franklin University, Human Resources Management

. Otterbein University, Business Administration

Licensure

State of Ohio license in Health, Life, AD&D, Variable Annuities, HMO and

Property and Casualty

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