TERRENCE DUANE SHELTON

*** ********* ***** • Hampton, VA 23666

Phone: (757) 759 - 9703 • E-mail: ac4kbt@r.postjobfree.com

Summary of Qualifications

Resourceful critical thinking

Project Management and Human Relations

Benefits Administration (Medical, Dental, Vision, Life, Retirement)

Knowledge in Organizational and Strategic Planning

Productive in high stress environment

Dynamic, knowledgeable and trusted advisor

Innovative problem solving

Annual reporting and compliance

Self Starter

High knowledge of HR principles

Excellent verbal/written communication skills

Ultipro, Oracle, BAAN, Kronos, HRIS, and PeopleSoft

Education

May 2002 Norfolk State University Norfolk, VA

Bachelor of Arts, Business Administration

June 2013 Walden University Baltimore, MD

Master of Business Administration

Professional Experience

December 2012 – October 2017 The Arc of the Virginia Peninsula Hampton, VA

Benefits Administrator and Employee Relations

Administer various employee benefit programs, (group insurance, life, medical and dental, voluntary benefits offerings, and retirement)

Reconcile and approve monthly premium statements/invoices for all group insurance policies and maintain statistical data relative to premiums, utilization, and costs.

Resolve administrative problems with the broker and/or carrier representatives where applicable.

Interviewing candidates for open positions.

Involved with the write up and termination process of employees

Handle all benefits inquiries and complaints (internal and external. Maintain contact in person, by phone or email, with hospitals, physicians, insurance companies, brokers, employees, and beneficiaries to facilitate proper and complete utilization of benefits for all employees and consumers.

Develop benefits information and statistical census data for actuaries, insurance carriers, brokers and management.

Implement new benefit programs; manage benefit open enrollment periods; arrange and conducts benefits orientation, information and enrollment presentations.

Manage the Family Medical Leave (FMLA) process

Assure The Arc’s compliance with provisions of the Employee Retirement Income Security Act and all other regulatory requirements (i.e. COBRA, PPACA [Patient Protection and Affordable Care Act]).

Process and maintain all status changes, pay changes, benefit deductions and additions in the electronic payroll system.

Track trend and development in assigned functional areas (including CARF).

Assist with documentation and maintenance of CARF and other relevant accreditation standards.

Serve as a back up to the finance department for payroll processing in accordance with the needs of the organization

April 2010- November 2012 SOI Ft. Mill, SC

Benefits Administrator

Assisted Benefits Manager with the administration of various employee benefit programs, which include medical and dental healthcare plans, Consolidated Omnibus Budget Reconciliation Act (COBRA) and Family Medical Leave Act (FMLA) and life insurance plans.

Prepared, administered and maintained records, files and reporting information for the various programs in accordance with SOI processes, procedures and regulatory requirements, which include LTD, unemployment claims and Pension eligibility.

Provided guidance and assistance to employees relative to the policies, practices, and procedures applicable in administering the SOI benefit programs.

Acted as liaison between employment benefit vendors and employees to ensure adherence to plan provisions and to resolve issues or concerns regarding plan administration.

Administered, maintains and coordinates on-line insurance plans, eligibility and premium payments transmissions; interacting with IT Designates, Vendors and employees.

Responded to unemployment claims and assists in protest claims with the Workforce Relations Manager and other Lab management.

Reviewed, determined eligibility and conducts employee enrollment meetings for pension, health benefit programs and other benefits.

Monitored, analyzed and researched utilization reports and trends for assigned benefit programs, i.e. Family Medical Leave Act (FMLA) & Long Term Disability (LTD), and compiles information and reports including recommendations on the addressed findings.

October 2004 - April 2010 Family Dollar Corporation Matthews, NC

Lead Benefits Administrator

Worked closely with third party vendors on data interface management.

Assisted employees with complex problem resolution, and accepted responsibility for resolving escalated issues.

Established relationships with various carries, including medical, dental, vision, life insurance, and financial planning.

Developed and motivated a team of 17 employees by identifying problems and offering recommendations for improvement.

Extensive knowledge of principles and procedures for personnel recruitment, training, compensation and benefits, labor relations, and personnel information systems.

May 1998 - January 2001 The Lash Group Norfolk, VA

Senior Benefits Investigator

Investigated types and levels of insurance coverage to assess drug coverage and patient eligibility for assistance.

Communicated with medical professionals and insurance company representatives in order to facilitate patient access to certain drugs and services.

Researched reimbursement policies for Medicare, Medicaid and private commercial insurance to resolve billing and/or account issues.

Documented communications with patients, medical staff, field reps and other authorized parties involved in patient care.

Accompanied sales reps on site visits providing reimbursement support in the North Central and Great Lakes regions.

Handled high-volume calls from patients, medical professionals, advocacy agencies, etc.

Performed advanced benefit verifications and provided a comprehensive understanding of benefit structures and reimbursement issues for infusion services, oral and injectable medicines (physician-administered medications) across all payer types.

Community Involvement

Big Brother Big Sister Charlotte

Urban League of the Carolinas

Norfolk State Alumni Association Chaplain

Skills

Standard office productivity software applications (i.e. Microsoft Office Suite)

Ability to compile, interpret and report complex statistical information

Confidentiality

Ability to work independently, make sound judgments, manage multiple projects, and meet deadlines

Strong communication skills – both written and verbal

Knowledge of regulations, standards and certification requirements related to benefits coordination

Ability to research information and analyze data to arrive at valid conclusions, recommendations and plans of action

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