Customer Service Manager

Lisa A. Vogeli

**** ********** *****, *********, ** 28227 704-***-**** *******@*********.***

Summary

Administration Professional with over 20 years of experience specializing in Benefit Administration and Customer Service. I am an accomplished individual with excellent organizational skills, competent, strong team player, and ability to handle multiple tasks and meet deadlines and excellent client/customer service skills with the willingness and ability to learn new tasks.

Skills

*MS Office proficient *Problem solving skills

*Benefit Administration *Analytical skills

*Strong Customer Service *Excellent work ethic

*Strong Client Relations *Self-motivated

Work History

Implementation Specialist/Document Writer, 10/2015 to 03/2017

Corporate Benefits Service, Inc. – Charlotte NC

*Responsible for plan design and document preparation in Microsoft Word, such as SPD’s, SBC’s and Schedule of Benefits for multiple clients; Explained benefits and schedules.

*Partner with Clients, Brokers and Account Managers to make sure all company benefits as well as eligibility information is stated correctly; communicated by telephone, e-mail or in person with internal staff, providers and clients to explain and assist with administrating policy and procedures accurately.

*Development of systems and procedures to ensure plan documents specs are maintained accurately and in sync with other systems; maintain company/client website ensuring all available information is accurate and available online.

*Headed up a team of 3 to review, interpret and apply Stop Loss Contracts.

*Accountable for facilitating accurate preparation, filing, and posting of necessary reports and Stop Loss claim filings to the appropriate carriers, posting and reconciliation of payments received; Researched payroll, COBRA, disability and FMLA issues.

*Identify and define issues, evaluate current process and refine to meet the needs of company, client and vendor.

Administration Specialist, 02/2011 to 09/2015

Complete Benefits Solutions – Charlotte NC

*Responsible for all aspects of the management and administration of Medical, Dental, Vision eligibility for multiple clients; Create, maintain, generate, reconcile, distribute and post payments for monthly billing to clients; COBRA administration, posting of premium payments and distribution of such payments, communicate with members to explain COBRA; Troubleshoot all billing issues, which included issuing debits, credits and post accordingly.

*Field customer service calls related to all eligibility and claims questions from Clients, Participants, providers and vendor; Supported Client’s HR staff during open enrollment; Explain benefits, schedules, leave policies and COBRA.

*Tracked monies paid on all members, prepared and filed 50% reports, review, interpret and apply Stop Loss contracts, received payments and reconciled each individual member’s account, post results in individuals file in claim system; completed and distributed Aggregate reports to client and Stop Loss carriers; create and maintain Plan Documents and Amendments; Educated and advised employees on group health plans.

*Managed the timely release of claims on a daily basis; produced and distributed weekly claims check register for 22 different clients; audited high dollar claims to ensure processed accurately and timely; correct the claim payments when identified, request, follow-up, process and post all refunds received into the claims system; Generate all necessary reports and upload to FTP site for client viewing; provide excellent customer service to our clients, their plan participants, providers and other outside vendors. Point of contact for all office issues; developed, instituted and maintained online office procedures for claims, customer service and billing departments, provide daily direction and system support to all departments; Train new employees on how to apply process and procedures in their daily duties.

Billing & Eligibility Specialist, 02/2004 to 02/2011

Medical Claims Management Corporation/MedCost – Charlotte NC

*Responsible for the set up for all clients monthly billing, maintain the billing rates for all existing clients; generate, audit and reconcile monthly billings prior to distribution; post monthly premium payment and issue any necessary debits or credits and post to each individual account.

*Management and administration of Medical, Dental and Vision eligibility for approximately 9,000 employees; responsible for COBRA administration; prepared, produced and distributed all necessary notification including ID cards and benefit confirmation letters for entire client base; provide telephone, e-mail or in person support and troubleshooting to all Clients, Brokers and Employees on all eligibility issues; assisted our clients with their open enrollment process; Educated and advised employees on benefits and leave policies.

*Partnered with Account Manager, Client and Brokers to design and draft plan document and amendments to benefit plans; maintain compliance of plan administration to plan document specifications for 40 different clients.

Plan Builder, 03/1998 to 01/2004

Employee Benefit Services, Inc. - Fort Mill SC

*Plan Building of medical, dental, vision and STD plans in Microsoft Word format; partnered with account manager, client and brokers to enter plan specs for claim administration; trouble shoot payment issues and create/implement processing procedures to ensure accurate claim payment results.

Stop Loss Coordinator/Plan Builder, 02/1992 to 03/1998

National Claims Administration Services – Charlotte NC

*Handled the administration of Medical, Dental, Vision and STD claims for multiple clients including handling all customer service calls from Client, Members, Providers and other vendors.

*Responsible for all corrections/adjustments to previously processed claims; request, track, follow-up and post all refunds received.

*Promoted to handle the filing of specific and aggregate Stop Loss claims.

*Promoted to Plan Building.

*Promoted to Claims Manager.

Education

High School Diploma: 1981

Longwood High School – Middle Island NY

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