Customer Service Manager

Billy J Alvarez

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

Leander, TX *****

Home 512-***-****

Mobile 512-***-****

Email abknji@r.postjobfree.com

OBJECTIVE

To obtain a challenging career where I can effectively utilize my

education, skills, and abilities which will provide an opportunity for

professional growth and advancement. To use my knowledge of insurance

policies and procedures, Section 125 Cafeteria plan guidelines and benefits

administration along with a high level of customer service to assist

clients/employees and further the mission and goals of my employer.

WORK EXPERIENCE

BURNETT STAFFING, Inc., Austin, Texas

Contract Employee/British Aerospace Systems, Inc.

Benefits Specialist Health and Welfare Programs Aug

2008 - June 2010

BAE Systems is the premier global defense and aerospace company delivering

a full range of products and services for air, land and naval forces, as

well as advanced electronics, information technology solutions and customer

support services. With 50,000+ employees worldwide as the Benefits

Specialist I provide assistance to the Director, Benefits Operations and

Administration and the Benefits Manager in support of the administration

and audit of BAE's benefit plans including all medical plans, dental,

vision, life, long term and short term disability of the Health and Welfare

programs.

. Review and audit all Cigna and Aetna Health Summary Plan Descriptions

for mapping errors, inconsistencies, misspellings, punctuations,

accuracy and communicating any errors to the Benefits Manager in order

to ensure benefit plan compliance.

. Audit employee's files in order to ensure the assignment of correct

benefits for their benefit codes depending on work location and title.

. Audit life, optional life, spousal life, dependent life, short term

and long term files of employees to ensure accuracy of amounts and

premium billed amounts according to the employee's payroll schedules.

. Assisted with testing of Hewitt's Benefits Navigator website in

preparation for this year's annual open enrollment. Created

spreadsheet error logs that were reported to the Benefits Manager and

Third Party Administrator's Benefit Service Manager on a daily basis

for proper resolution and improvements.

. Provide other special projects assistance for all programs and team

support as needed.

BENEFITS DESIGN, Inc., Austin, Texas

Regional Benefits Administrator /HRIS Jan 2007

- Jul 2008

Provide benefits support for 8,000+ employees and HR contacts across the US

on a day to day basis. Administrative daily operations of group benefit

programs; including but not limited to: group health, dental, vision, life

insurance, short term and long term disability, flexible spending accounts

and long term care.

. Establish and maintain effective positive working relationships with

client, third party benefit vendors and team members.

. Perform accurate data entry into the Human Resource Information System

(HRIS) regarding applicants, new hires, and status changes (applicant

flow log, new employee set up, benefit elections and changes,

terminations) to assure timely benefit enrollments.

. Ensure employee benefit eligibility for all plans by communicating

discrepancies and assist in ensuring data integrity.

. Provide customer support for employees addressing benefit

inquiries/complaints and insurance claim discrepancies to ensure

quick, equitable, and courteous resolution in a timely manner.

. Perform and process benefit adjustments for semi-monthly payroll.

. Knowledge of client employee benefits policies, and procedures and

processes.

TEXAS MUNICIPAL LEAGUE INTERGOVERNMENTAL EMPLOYEES BENEFITS POOL, Austin,

Texas

June 2001 - Aug

2006

Billing & Eligibility MSR - Benefits Coordinator/HRIS/HR Specialist

Sep 2003 - Aug 2006

Benefits coordinator for administered/managed groups/cities that also

included working with three Benefits Service Specialists located in service

areas throughout the state of Texas.

. Consulted with cities and group's Human Resources in understanding the

policies, procedures and guidelines for 200 plus groups for 5000+

lives on a daily basis.

. Setup/establish new groups/business, enrolling/entering data,

maintaining, managing current employee/dependent data.

. Administered all aspects of COBRA on a weekly basis.

. Responded to Human Resources, employee/pharmacies inquiries; analyzed

and researched prescription claim issues.

. Completed monthly premium reconciliation, balanced billing statements,

new/current flexible spending account set ups/reimbursements;

processed death claims.

Growth Pool Team June 2001 - Aug

2003

Assisted members/providers with inquiries pertaining to claim status,

policies, and procedures in reference to the multitude of different plans

for government entities that are administered by TML and provided quality

customer service in an accurate and timely manner on a day to day basis.

. Analyzed, researched problems and solved them while interfacing with

pharmacies and doctor's offices when necessary.

. Assisted Billing & Eligibility Analysts when needed with loading of

new hires, employee terminations, changes, creating and mailing of

COBRA offers and billing for participating groups.

ELECTRONIC DATA SYSTEMS / NATIONAL HERITAGE INSURANCE Co., Austin, Texas

Aug 1992 - June 2001

Research Analyst June 1998 - June

2001

Demonstrated ability to manage time, resources, and prioritize work

assignments.

. Demonstrated success in written and verbal communications skills

between NHIC and the Texas Department of Health in reference to

Medicaid Client complaints filed against Texas Medicaid Providers.

. Demonstrated success in problem solving; detail oriented.

. Ability to interact with three Provider Service Representatives

located in service areas throughout Texas, in-house claims department,

in-house medical management, customers, office managers, corporate

personnel, doctors and collection agencies to resolve provider issues

and problems.

. Responded to communications between NHIC, providers, Texas Department

of Health, and Medical Associations in a timely manner.

. Assisted providers with claims appeals and processing according to

Texas Medicaid Guidelines.

Customer Service Representative Aug 1992 -

May 1998

Assisted providers with the Texas Medicaid program by providing quality

customer service in an accurate and timely manner.

. Responsible for responding to inquiries relating to Medicaid claims,

provider enrollments into the Texas Medicaid program and providing

Texas Medicaid benefits verification.

PROFESSIONAL SKILLS

Excellent organization, communication, and analytical skills. Ability to

work effectively and efficiently under pressure to meet tight deadlines.

Punctual with a strong sense of responsibility and self-motivation, great

problem solver with leadership and team player abilities. Knowledge of

Word, Excel, Trizetto Rims Software, PeopleSoft and the ability to learn at

a fast pace other commercial or company computer systems.

EDUCATION

ITT Technical Institute, Austin, Texas June 1990 -

Aug 1991

Computer Aided and Manual Drafting

Graduated Schulenburg ISD, Schulenburg, Texas May 1986

REFERENCES

Provided upon request

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