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Customer Service Sales

Location:
Sacramento, CA
Posted:
November 19, 2014

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Resume:

Jeané Blair (JB)

Sylmar, CA

Phone: 818-***-**** Email: acgr3x@r.postjobfree.com

Education / Licenses

UCR-University of California-Riverside, Riverside, CA

**/****- **/****

Bachelor of Arts: (Double Major): Political Science & History

California Department of Insurance License, Life Agent & Accident and Health

eff. 11/09/2002 - exp. 11/2016

License # 0D83398

Skills

Microsoft Office 97-2013 BpSOR Siebel Project IRS TIN

Lotus Notes A.B.S. SQL Visio Matching

Business Objects SAP Callidus Oracle

File Maker Pro MACESS Snag-It Health Connect

Qualifications

Successful compliance project management and training experience

Solid problem-solving skills, and risk assessment

Proficient in developing reasonable assumptions based on insufficient information

Strong knowledge of massive records management, SOX policies, and ICAS policies and procedure

Demonstrated ability to work independently, as a team, or as a peer lead

Capable of handling simultaneous tasks, while meeting challenging/ conflicting deadlines

Skilled in finding system solution and improvements, remedies, and increasing productivity

Well-developed communication and leadership skills

Self-motivated and disciplined

Experience

Health Net, Inc. Woodland Hills, CA- Broker Commissions Specialist (Accounting)

05/06/2013 to Current

Process monthly broker commissions, and produces management Ad-Hoc reports as assigned

Interacts with broker and sales force to provide customer support on any commissions/related inquiries.

Assist with escalating broker commissions and or pay related issues

Processes adjustments to correct commission errors and/or discrepancies.

Works with IT to ensure timely reporting and payment of monthly commissions.

Facilitates policy and procedures by monitoring necessary work steps to maintain program and project goals

Maintains the master broker system and takes necessary steps to ensure correct reporting of 1099 information.

Assists and participates in any cross training necessary for new employees, in their areas of expertise.

Compiles data and issues “Form 5500”, and “Schedule A” information to the appropriate groups in accordance with IRS

specifications

Performs monthly reconciliation of cash to the general ledger which is used to calculate the monthly commission

payments.

Rose International Inc. (contractor) Kaiser Permanente Burbank, CA -Broker Compensation Specialist (Accounting)

06/17/2012 to 02/27/13

Provide complete compensation support to all contracted brokers

Health Net, Inc. Woodland Hills, CA- Compliance Analyst /Project Management

07/2006 to 09/2010

Continuous monitoring & auditing of Health Net’s Commercial, Medicare, and MHN associate compliance with the

various state Departments of Insurance, federal insurance regulators, and internal sales associate guidelines. Followed up

with company risk and liability assessment reports to management, and implementation of corrective plan(s) of action as

necessary.

Coordinated performance evaluations of Associates, contracted Agents/ Brokers, and/or DBA’s with legal counsel and/or

Human Resources Department to assess any company compliance violations. Under supervision, enforced consequences

for non-compliance, such as suspension and/or termination of associates or contract agreement termination for Agent/

Brokers.

Lead multiple department projects as project manager with a team of three associates. I facilitated policy and

procedures, monitored and revised necessary work steps to maintain program and project goals. I managed all project

issues dealing with human resource management, communications, marketing, budgeting, and risk management, all

while staying on top of project scope and timeline.

Slashed internal (HN Inc.) and external (DMHC, CMS, DOI, SOX and HIPPA) audit administration cost by 40%, by assuming

the lead role in preparing and or delegating all company audit and filing requests. I also performed SOX compliance

audits and policy and procedure review and kept apprised of all HIPPA regulations effecting how we do business. I am

also familiar with UAT test plans. I lead a cross-functional compliance unit which maintained relevant compliance files

and I directly oversaw all compliance administrative duties. As the main point of contact for company requests, I ensured

the continuation and enhancement of these company required services.

Research, analyze, and created policy and procedure that kept Management, Sales associates and Agent/Brokers

appraised of all relevant regulatory updates, changes and /or modifications in state and federal law. Educated associates

quarterly on relevant regulatory updates effecting the companies’ compliance. Suggested strategies and implemented

necessary preventative actions to optimize results.

Responsible for weekly, monthly, quarterly and annual reporting/ filing, performed mock auditing, and risk assessment of

both Agent/Broker and internal sales associates.

Health Net, Inc. Woodland Hills, CA Compliance Monitor

02/2002 to 07/2006

Organized and arranged multiple unit peer projects; involving massive Agent/ Broker file clean-up to meet regulatory

(state specific Departments of Insurance, DMHC, CMS, and HIPAA) standards.

Prepared legal documentation required to dispute company liability in lawsuits. Also supported the Finance and the

Actuarial Departments in preparing yearly or bi-yearly Agent/ Broker information reports. (AM Best Report, Professional

Liability Insurance renewal)

Investigate and create reports regarding any and all misconduct and or fraud on the behalf of contracted Agents/Brokers

with the California DOI, CMS and DMHC that would lead them to be non-compliant with our contractual agreement

and/or state/federal law. Also responsible for maintaining accurate records of those Agents/Brokers.

Health Net, Inc. – Multiple Products Rep. III, Customer Service

12/2000 to 02/2002

Responsible for handling over 100+ HN member calls daily. Used Macess, A.B.S., and the pharmacy (PCI) system to access

member pharmacy information regarding prescriptions and payment.



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