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Human Resource, Account Manager, Account Execuvtie employee benefits

Location:
Henderson, NV
Salary:
$60,000
Posted:
June 12, 2018

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Resume:

ESTEL TARWATER

**** ********** ******,

Henderson, Nevada 89044

H: 702-***-**** C: 702-***-****

ac5uqw@r.postjobfree.com

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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