Robin Little

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

Baton Rouge, LA 70817

[H]: 225-***-****; [C]: 281-***-****

E-Mail: ac1yjz@r.postjobfree.com

OBJECTIVE

Multi-state licensed Group Life and Health Benefits Analyst/Administrator, Relationship Manager, degreed in Psychology and a proven 20-year successful track record of planning, organizing and coordinating with vendors, employers and employees in bringing them the coverage types and service expected from the top names in the Insurance Industry by active listening and procuring requests for proposals that fit and exceeded their needs in addition to following-up with the highest standard of quality service, seeking position in which these skills may be utilized.

PROFILE

Demonstrate excellent ethical, management, negotiation and enthusiastic customer and vendor relation skills. Successfully resolve issue with regards to coverage types sought, and unsought, by employer, enrollment, billing and claims issues and concerns. Predominant attention to detail, excellent written and verbal communication skills, strong time management discipline and the ability to perform multiple projects simultaneously.

SKILLS SUMMARY

Project Management

Request For Proposals

Report Preparation

Collect/Analyze Utilization Data

Prioritizing

Client Relationship and Retention

Oral Communication

Written Communication

Self-Disciplined Juggler

Professional Presentations

Psychological Aptitude

Medical Terminology

Reconcile Billing Issues

Insurance Product Expertise

Ethical and Moral that is non-negotiable

Medical and Rx Claims Resolution

PROFESSIONAL EXPERIENCE

AlwaysCare/Starmount Life Insurance Company/UNUM

Group Specialist (Relationship, Benefits and Billing Specialist): 2011 to Present

Essential Duties and Responsibilities:

Serves as a regular contact for internal customers, insurance vendors and/or third party administrators

Investigates discrepancies and provides information in non-routine situations

Maintains records and prepares documents for implementation and maintenance of coverage

Investigates coverage and premium discrepancies

De-escalate all critical level benefit and premium issues which may involve conference calls between the client, the broker and/or vendor and myself

Provide expert consultation and telephonic counseling services

Utilize critical thinking, communication, and documentation skills at a high level in multiple settings with clients, brokers and vendors to evaluate best course of action for escalated and critical coverage and billing issues

Proactively provide input in benefit and premium meetings and leads discussions to facilitate appropriate intervention in collaboration with directors, brokers and client appointed professionals to set reconciliation strategies

Operating standard office equipment and using required software applications to produce correspondence, reports, electronic communication, spreadsheets and databases

Partner with other functional areas to accomplish objectives.

Organize, manage, and track multiple detailed tasks and assignments with frequently changing priorities and deadlines in a fast-paced work environment

Communicate effectively, both orally and in writing

Work independently as well as collaboratively within a team environment

Keep all appropriate parties up-to-date on decisions, changes and other relevant information

Articulate reasoning behind actions

Provide a high level of customer service

Maintain strict confidentiality

Establish and maintain effective working relationships at all levels of the organization

Shel-Ray Underwriters

(Management Company for Great Midwest Insurance Company)

Client Underwriter / Benefits Administrator: 2006 – 2011

Responsible for managing Small Employer Group Health plans for South and East Texas

Responsible for ideology & implementation of new medical plans to sell to existing & potential clients

Advised Owners, CEOs, Reinsurers of opportunities to improve contracts to strengthen business potential

Provided skilled analysis of claim data, telephonic counseling techniques, interpersonal relationships, medical knowledge, application and interpretation of insurance and legal information, and in oral and written communication

Worked with Sales Team to implement coverages for new clients

Responsible for Performance Management Annual Review of Claims TPA & presenting said findings

Updated all medical and prescription data, census changes, rate factors and medical loads for each client at renewal.

Coordinated renewal of the client with the broker, prepare spreadsheets with renewal and alternative benefit designs

Implemented all new groups, group plan changes and group terminations

Managed claims data, maintain client underwriting worksheets with updated claims and medical data

Attended Webinars for the American Recovery and Reinvestment Act (ARRA) of 2009

Account Manager / Benefits Associate: 2001 – 2004

Issued all Contracts and Certificates for all new and renewing clients

Implemented all new groups, group plan changes and group terminations

Completed all open enrollment requests, applications, coverage changes, and/or new plans in a timely manner

Resolved all escalated service and claims questions/issues successfully and in a timely manner

Successfully executed new HIPAA rules and regulations

Marsh & McLennan Companies

Benefits Analyst: 2004 – 2006

Provided technical and analytical support to Health and Benefits clients

Worked with sales teams to implement all products for new clients

Prepared Request for Proposals – prepared and presented benefit and alternative benefit design spreadsheets to new and renewing clients

Worked with Carriers to ensure timely delivery of client materials

Collected, analyzed and interpreted benefit plans from all A-Rated Carriers, reviewed experience data, estimated future plan costs and calculated plan prices

Coordinated, attended and provided support for Annual Enrollments

Prudential/Aetna US Healthcare

Benefits Consultant: 1997 – 2001

Responsible for creating HMO, PPO, POS and Dental contracts and employee benefit materials for clients utilizing in-house custom software programs as well as other computer programs

Tailored each contract to accommodate special client requests, state and federal laws and changes in industry practices and procedures for all 50 states

EDUCATION

Florida State University

Bachelor of Science Degree in Psychology, 1995 GPA: 3.95

Primary studies in Performance Management

Texas General Lines Agent: Life, Accident, Health & HMO – License number 1288786, Expires 02/09/2019

Louisiana General Lines Agent: Life, Accident, Health & HMO – License number 536503, Expires 02/09/2018

COMMUNITY

Volunteer for the Habitat for Humanity

Volunteer Hotline Crises Counselor

REFERENCES

Available upon request

Contact this candidate