Human Resource, Account Manager, Account Execuvtie employee benefits
Resume:
ESTEL TARWATER
Henderson, Nevada 89044
H: 702-***-**** C: 702-***-****
********@***.***
PROFESSIONAL SUMMARY
In the Health Care Industry, a highly experienced Sales & Account professional with proven management skills. I serve as a Counselor, a Guide, a subject matter Expert, and most of all, a Partner. Proven ability in account oversight and client interactions. Ability to resolve conflicts, supervise account activity and provide client-specific policy guidance. Extremely adaptable and extensively involved in client interactions to achieve the goal of
providing optimal account support and guidance. Excellent presentation skills and the ability to think on my feet with decisions regarding products and services. Strong focus on Client Relations, Account Retention and Account Management. Able to manage and mobilize teams to accomplish strategic objectives and contracts.
Experienced Human Resource Generalist in the core areas of Benefits administration, FMLA/ADA administration, HRIS processing, Compensation & Classification, New Hire On-Boarding, Recruitment and Personnel Policy Training.
COMPETENCIES
Fluent in Spanish Experienced Business Developer
Experienced Negotiator Experienced in Market trend analysis
Strong organizational skills Enthusiastic yet professional
Detail-oriented in data analysis Health Care & Insurance Software
LANGUAGES
Fluent in Spanish
ADDITIONAL INFORMATION
Certification/License: State of Nevada Life and Health Insurance License since
1991 (includes continuing education required for renewal)
WORK HISTORY
INSURANCE BROKER 1998 to Present
T-Insurance & Human Resource Consulting Services
2144 Bannerwood St.
Henderson, Nevada 89044
As A Broker I provided Human Resource support to employer groups for employees, maintain and update all ACA laws, regarding HIPPA, FMLA, Cobra and employment laws with state and federal. Coordinate and conduct new hire orientation on insurance benefits. Review carrier contracts, rates, and benefits for accuracy. Negotiate yearly renewal on behalf of the employer with the carrier. Presented employee enrollment meetings both in English and Spanish. Completed the ERISA Plan Document on behalf of the employer, terms changes and employee enrollments on the carrier portals. Implemented new benefits and Wellness programs for employees on behalf of the employer groups. Compliance calendars, renewal timelines to keep employers timely for all renewals and any employer filings. Collected Schedule A’s on behalf of the employer groups for the 5500 Form filing.
SALES ASSOCIATE (Part-Time) 2005 - Present
Pottery Barn
2265 Village Walk Dr.
Henderson, NV 89052
Serve as a retail sales clerk with exceptional cash handling accuracy and assist all customers with information regarding the items in the store. Develop and manage customer relations by means of referrals for designer home appointments. Excellent teamwork skills, high level mentoring skills when training new sales associates. Continually motivate other team members to achieve goals and use people skills to build group involvement and support management.
ACCOUNT MANAGER – (Large & Small Accounts) 2013 to 2/12/18
Brown & Brown Insurance
975 Kelly Johnson, Suite #100
Las Vegas, Nevada 89119
Account Management and Account Retention of 75 employer group accounts of large, small and 50 individual clients, day-to-day service related to employee and employer issues. Negotiated insurance renewal rates and benefits with carriers on behalf of the employer. Presented employee meetings both in English and Spanish. Processed employee enrollments, changes, and terms on behalf of the employer on carrier portals. Reviewed carrier contracts on behalf of the employer for accuracy. I assisted employees with provider issues, prior authorizations, making provider appointments, filing claims grievance and complaints. Worked with the HR contacts to make sure they were in compliance with all state and federal laws related to employment laws. Assisted in processing FMLA, Qualifying Event, and Cobra documents. HR administration and coordinated and conducted new hire orientation on insurance benefits. Implemented new employer enrollment platforms and Wellness programs on behalf of the employer. Completed the ERISA Wrap Plan Documents for the employer medical benefits. Generated the renewal compliance and timeline calendars for employer groups to stay in compliance with state and federal filing. Collected and assisted with the Schedule A's for 5500 form filling. Worked daily with multiple producers on implementing new group benefits. Managed daily Account Coordinator job duties as assigned by Account Managers and producers. Worked with TAM The Agency Manager system daily creating activities on renewals, compliance, contracts and all service issues.
HUMAN RESOURCES LIAISON 2008 - 2012
Rhodes Homes
6345 S. Jones Blvd.
Suite 400
Las Vegas, NV 89118
Experienced Human Resources Generalist in core areas of benefits administration. Managed large, small and individual clients benefit daily. Assisted HR with employee issues related to claims, providers, complaints, prior authorization, and enrollments. Processed employee enrollments, changes, terms, Cobra and HIPPA on behalf of the employer on carrier portals. Reviewed carrier contracts and monthly invoices for accuracy. Conducted employer meetings both in English and Spanish. Maintained all clients in compliance with state and federal employment laws. ERISA Plan Documents, Schedule A's, 5500 Forms. Assisted with FMLA, ADA administration, HRIS processing, Compensations & Classification, New Hire on boarding, Recruitment and Personal Policy Training.
SALES EXECUTIVE 1991 – 1998
Sierra Health Services, Inc.
2720 N. Tenaya Way
Las Vegas, Nevada 89128
SUBROGATION SPECIALIST 1989 – 1991
Sierra Health Services, Inc.
333 N. Rancho
Las Vegas, Nevada 89108
Provide expert claims support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customer and government entities by means of Coordination of Benefits and third party claims. Negotiated with attorneys on claims for automobile, accidents and medical liens with recovery rate success of over 80% of assigned accounts. Reprocessed Coordination of Benefits (COB) claims, telephone members for information regarding third party insurance and preexisting conditions. Investigated claims fraud and overpayment on claims, analyzed and identified trends and provided reports as necessary to management. Ensured adherence to state and federal compliance policies, reimbursement policies and contract compliance. Dealt with provider office on claims overpayments for recovery of overpayment.
CLAIMS SPECIALIST 1986 – 1989
Sierra Health Services, Inc.
333 N. Rancho
Las Vegas, Nevada 89108
MEMBER SERVICES REPRESENTATIVE 1985 – 1986
Sierra Health Services, Inc.
333 N. Rancho
Las Vegas, Nevada 89108
Full-time Parent 1980 - 1985
Education
High School – Rancho High, 1980 Diploma
College – University of Phoenix
References & Salary History
Furnished upon Request
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