Janice L. Ruff

**** ***** **** #**** ******, GA *0096 404-***-**** z4w5yy@r.postjobfree.com

Career Summary

Accomplished human resource and benefits professional with 14 years of proven effectiveness in administration, supervision and management of defined benefit and of group health plans. Possess exceptional planning and communication skills as well as the capacity to work well under pressure, meet tight deadlines, and function successfully as an individual, or as part of a team. Excellent people management skills with the ability to motivate and guide staff toward meeting organizational objectives. Broad knowledge of ERISA and federal regulations such as COBRA, Health Care Reform and HIPAA. Extensive experience in creating and maintaining relationships with insurance carriers, medical providers and vendors.

Professional Experience

Account Manager 2010 – Present Brown & Brown Insurance of GA, Inc. Duluth, GA

• Administer employee benefits programs such as health, vision, dental, long term & short term disability, and dental.

• Initiated and managed key benefit processes (annual benefit statements, Health Care Reform, COBRA compliance, ERISA & DOL compliance).

• Lead and monitored all online eligibility, all aspects of HR, benefits and payroll administration.

• Provided team of brokers with a comprehensive analysis of insurance benefits, medical rates, plan utilization analysis and identify any applicable access issues.

• Effectively process eligibility changes, enrollment and benefit changes via facets for various carriers.

• Manages human, financial and material resources to ensure a high quality, cost effective and responsive health care service.

• Supervised and managed the carrier submission of new group or renewal applications.

• Responsible for planning, overseeing and facilitating oral presentations and service proposals for active and/or prospective clients.

• Act as a liaison between employees and insurance providers regarding employee benefits and coverage

Client Advocate 2008 – 2010 Kapnick Insurance Group Southfield, Michigan

• Prepare monthly reports for sales representative and clients.

• Lead and monitored all online eligibility, all aspects of HR, benefits and payroll administration via bswift.

• Effectively support system by applying system policies and standards through the appropriate systems.

• Troubleshoot various systems to ensure that benefit plans are loaded correctly.

• Provided team of brokers with a comprehensive analysis of insurance benefits, medical rates, plan utilization analysis and identify any applicable access issues.

• Supervised and managed the carrier submission of new group or renewal applications.

• Broad knowledge of ERISA and federal regulations such as COBRA and HIPAA; and the oversight/administration of SPD’s and 5500’s.

• Lead open enrollment meetings, health fairs and wellness programs with vendors/clients.

• Maintain client database information in accordance with established internal procedures.

• Prepared oral presentations and service proposals for active and/or prospective clients.

• Create COBRA and HIPPA manuals, summary plan descriptions and compliance guides.

• Provide day-to-day hands-on support of COBRA and other benefit programs.

Service Consultant 2004 – 2008 Flynn Benefit Group Troy, Michigan

• Managed & administrated multiple health, dental and vision plans, Health Saving Accounts, FMLA, COBRA, Pharmacy Benefit Management (PBM) and disability plans.

• Research, analyze, evaluate, design and manage integration of benefit plans/programs.

• Promote teamwork coordination on proper follow-up on responses to benefit issues.

• Design and implemented procedures for organizing and maintaining firm documents.

• Research client/prospect to develop Request for Proposal (RFP) and send out to bid to carriers.

• Supervise and monitor issuance of required regulatory mailings and notices.

• Ensure all benefit plans, policies and programs are compliant with legislation, and provide counsel and direction to senior management, and operations staff as needed.

• Conduct benefit plan audits and ensure government compliance of policies & procedures.

• Plan and manage open enrollment presentations with clients to review benefit packages.

• Proactively scheduling follow up meeting/visits to enhance the client/agent relationship.

Account Service 1998 – 2004 Blue Cross Blue Shield of MI Southfield, Michigan

• Ability to handle large amounts of incoming calls in a call center setting.

• Identify documents, recommends and implements effective approaches to use system functionality in the most productive way.

• Support system and date needs by applying NASCO policies and standards as appropriate throughout product/project delivery.

• Educated and trained new and current employees on benefit changes, updates and optimum utilization of benefits.

• Responsible for front end claim processing and back end adjudication for professional and facility claims.

• Analyze/research and investigate customer inquires for various lines of business.

• Day-to-day contact with the HR representatives; solved issues and provided interpretation of benefits.

• Conduct internal/external research to determine and request needed data.

• Trained on HIPPA, DOL/ERISA, and full understanding of CPT and ICD- 9CM coding.

Education

University of Phoenix, Sandy Springs, Georgia - Candidate for Master of Health Administration

Expected Graduation: August 2013

Davenport University, Livonia, Michigan - Bachelor of Business Administration – Human Resource Management: Graduated - August 2011

Professional Certifications and Licensure

Licensed Producer, Georgia - Life, Accident and Health

References

Available upon request

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