Linda McBride

Health Benefits Administrator, MBA

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

North Canton Ohio 44720

330-***-****

ab8c81@r.postjobfree.com

PROFESSIONAL PROFILE

MBA Health Administrator with over 10 years of experience leading and executing health administration processes and

systems. Implementing and coordinating annual enrollment and creation of plan specifications. Effectively handle

issue and escalation resolution, including root cause analysis and implementation of long-term solutions. Exhibiting

high ethical standards and knowledge and understanding of applicable health and welfare benefits related laws and

regulations affecting national health care.

SUMMARY OF SKILLS AND QUALIFICATIONS

Leadership, guidance, coaching, and staff development skills, as well as, conflict resolution.

Technical and software acumen utilizing statistical tools to evaluate data and to reach probabilistic solutions.

Oversee the Request for Proposals (RFP) bid renewal process and Request for Information (RFI) with Third Party

Administrator (TPA) and contracted vendors.

Tracking stop loss and reinsurance reimbursements, subrogation claims, tracking arrears, COBRA, HIPAA, FMLA, and Life.

PROFESSIONAL WORK EXPERIENCE

City of Canton – Human Resource Benefits Administrator

Canton, Ohio January 2009 to Present

• Leading and overseeing all Benefits Administration operational activities for Self-Funded Section 125 Plan.

• Overseeing the development and execution of health and welfare benefit administration processes and systems.

• Directing all aspects of the medical, dental, vision and pharmacy benefits, as well as, COBRA, life, and disability

policies.

Developed Wellness Program for employee population.

• Presenting benefit related issues to organization’s leadership team, broker, legal council and City Council officials to

provide review of reporting and interpretation of applicable policies and procedures.

• Monitoring system processes, benefit interface file execution.

• Customer Service solving complex problems and issues.

• Negotiating with third-party vendors, contractors, and business partners for cost effectiveness of benefits program.

• Researching HR benefit industry trends and developments.

• Ensuring benefits contracts meet State and Federal laws, HIPPA guidelines and social service benefits verification.

• Researching and recommending amendments to contracts as needed.

• Tracking stop-loss and reinsurance contract arrangements.

• Communicating benefit to employees and dependents, healthcare reform and PPACA regulations.

Adjunct Instructor October 2009-Present

Malone University College, Canton Ohio

Brown Mackie College, Akron Ohio

Linda McBride

Providing education and training through online and ground class structure to a diverse population of adult students

entering the field of Healthcare and Health Management. Teaching the principles, concepts and methodologies relating to the

delivery models, finance and legal aspects of healthcare, and community or public health.

Patient Financial Service Department Manager

North Canton Medical Foundation, North Canton Ohio November 2007 to June

2008

Managing all aspects of the billing and coding staff within the foundation.

Collaborating with other departments in developing and improving clinical and administration policies and procedures

and streamlining workflow and operations. Ensured that all work performed is in compliance with federal and state insurance

regulations.

Analyzing financial data reports and adhoc reports, monthly accounts receivable reporting, insurance denial analysis

reports and capital budget reports. Compiled monthly reports and analyzed statistics to identify patient satisfaction, clinical

operations and reimbursement trends.

Benefits Quality Assurance Manager and Trainer

Emergency Medical Physicians, Canton Ohio April 2005 to

November 2007

Managing, leading and training within the Medical Billing and Financial Services (MBFS

Responsible for project management including; benefits, HIPAA staff testing and training, software implementation and

relocating California office staff throughout facility.

Leading auditing staff through coaching philosophy.

Providing business requirements to technical team for staff training and testing.

Responsible for writing policies and procedure online manual for training and daily operations.

Health Benefits Coordinator / Reinsurance Analyst

Aultman Health Foundation – TPA AultCare, Canton Ohio September 1998 to

April 2005

Overseeing self-funded plan implementation.

Tracking and analyzing large dollar medical claims accumulating toward stop-loss and aggregate limits

according to contractual agreements.

Negotiating with insurance carrier representatives and underwriters for client renewals and procurements.

Managing vender implementation and day-to-day issues with client.

PROFESSIONAL ACCOMPLISHMENT

• 2011 Speaker at Ohio 6th Annual Wellness Conference, Columbus Ohio

• Mayor’s Proclamation Honoring Instructor of Students of Malone University Health Services

Management Program

Linda McBride

• Ecollege EDU 101B eCertification: Teaching Online Courses

• International Business Studies Rome American Hospital, Rome Italy

EDUCATION & CREDENTIALS

MBA - Walsh University (08/20/2006 - 08/01/2007)

North Canton, Ohio

Degree: MBA-Major: Master Degree; Minor: Health Administration

GPA: 3.8 Semester Hours: 24

Malone (01/01/2004 - 05/30/2006)

Canton, Ohio

United States

Degree: Bachelor of Science-Major: Management; Minor: Human Resource;

GPA: 3.8 Semester Hours: 24

Stark State College of Technology (01/01/1995 - 05/30/1998)

North Canton, Ohio

United States

Degree: Associates-Major: Accounting

GPA: 3.5 Semester Hours: 24

TECHNICAL SKILLS

Microsoft Office Products including Word, Excel, Access and PowerPoint, Lotus Notes, QuickBooks, Intuit

Tax, Practice Management Systems including RIMS, IDX, Onbase, NextGen and Medical Present Value,

Phynance. Experience with Oracle, SAP People Soft, SQL, Citrix Servers and Banner Database for City of

Canton.

PROFESSIONAL ASSOCIATIONS

Employers Healthcare Coalition, Ohio Healthcare Coalition

International Foundation of Employee Benefit Plans

Medical Group Management Association (MGMA)

Healthcare Financial Management Association (HFMA)

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