Medical Insurance

Kevin R. Kreis

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

Latham, NY *****

C-518-***-**** / H-518-***-****

Email: *********@*****.***

OBJECTIVE: To move into a more advanced leadership position in Employee

Benefits and Human Resources Administration.

EDUCATION

1989. Bachelor of Science, SUNY Institute of Technology at Utica/Rome

1988. Associate of Applied Science, Mohawk Valley Community College

EMPLOYMENT

Health Benefits & Claims Coordinator-Catskill Area Schools Employee

Benefits Program

Otsego Northern Catskills BOCES

2013 - Present

Responsibility for coordination of a self-funded consortium offering

health, dental, worker's compensation, and flexible benefit plans.

Contacting employees, retirees, and insurance carriers for the purpose of

ensuring effective program operation and resolving individual problems.

Promotes health insurance programs, reviews enrollment applications, and

provides technical assistance to enrollees regarding benefits.

Responsibility for program administration with subcontractors,

representatives of insurance companies, and the ONC BOCES to develop and

update procedures for enrolling employees. Supervision over the work of

Senior Claims Processors, Claims Processors, and clerical staff.

Human Resources-Benefits Administrator, NYS Insurance Fund

2012-Present

Benefits Administrator for NYS Insurance Fund employees throughout NYS.

Provide guidance to new and existing union and non-union employees

regarding their benefits which include Medical, Dental, Vision, M/C Life

Insurance plans, Long-Term Care Insurance, Deferred Compensation, Flexible

Spending plans, Family Medical Leave Act (FMLA), Disability, and Worker's

Compensation. Make determinations regarding eligibility of employees and

dependents for benefits and make changes to enrollment files as necessary.

Conduct background investigations of prospective employees, new-hire

orientation, and employee training regarding their current benefits and

their benefits when they retire.

Senior Instructor, Department of Medical Studies, Mildred Elley

2011-2012

I am currently a professor in the Department of Medical Studies teaching

Medical Insurance and Medical Office Management. This includes giving

practical instruction in HIPAA Privacy Rules and Practices, medical

information and record management, common insurance carriers, government

programs, legal issues, medical insurance claims coding and filing, claims

processing, appointment scheduling, financial management, and proper

medical office written and verbal communications.

Supervisor, Benefit Services (G18), NYS Dept. of Civil Service

2005-2012

Supervisor of a group of representatives providing guidance to client

agencies and enrollees in the administration of the New York State Health

Insurance Program (NYSHIP) for both union and non-union employees and

retirees. Make final decisions on determining eligibility for benefits.

. Expertise in the benefit plans provided by 12+ health insurance

carriers, 3+ PBMs, and contracted dental and vision plans; as well as

Medicare Advantage.

. Handling of more complex written and telephone inquiries referred by

subordinates regarding pre-retiree and retiree benefits, FMLA,

Workers' Compensation, union and non-union benefits, waivers of

premium, and benefit administration.

. Leader and developer of training sessions and seminars throughout NYS

for NYS employees and retirees regarding their benefits, policies, and

procedures of NYSHIP. Small and large group presentations.

. Special Achievements:

o Selected to collaborate on production of NYSHIP benefits,

policies & procedures training video in cooperation with the NYS

Governor's Office of Employee Relations. Online: Oct. 2010.

o Selected to represent Rx concerns in RFP contract negotiations.

. Utilize MSWord, Excel, Access, FileNet and NYBEAS, NYSTEP, and PayServ

(PeopleSoft) dual screen technology.

Unemployment Insurance Investigator, NYS Dept. of Labor

2004-2005

Investigated cases of alleged fraud or collusion by claimants or employers,

employee misconduct, and complex cases involving self-employing entities

and corporations to determine claimant eligibility.

. Conducted formal examinations involving sworn testimony of employers,

claimants, and witnesses.

. Analyzed evidence and issued determinations on behalf of the

Commissioner of Labor, including cases referred to the District

Attorney for prosecution.

Correction Officer, NYS Dept. of Corrections

1994-2004

Provided supervision, security, and care of inmates both inside and outside

a correctional facility.

Senior Medical Claims Examiner, Metropolitan Life Insurance Company

1987-1994

Supervisor of Adjustment and System Team (6 claims examiners) in medical

claims examination and payment reconciliation.

. Provided guidance to members, other insurance carriers and attorneys

regarding medical benefits.

. Handled complex cases regarding recovery of overpayments from members

or providers, and subrogation recovery cases with worker's

compensation and auto insurance carriers.

. Leader of training sessions of employees on new claim payment systems.

. Special Achievement: Selected to transfer to New Mexico to service

new major account: US West. Promoted to Senior Medical Claims

Examiner.

Specialist Four, United States Army

1983-1985

Honorably discharged veteran of the United States Army, stationed in

Germany.

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