*** ******* ***** *****, ******* TX 78641
Telephone: 512-***-**** d email@example.com
**** *. ******* ****** * ndianapolis, IN 46280
04/2018 to present
Policy Enforcement Associate
01/2018 to present
Applied the client’s policies, community guidelines and other standards to ensure a high degree of accuracy, timeliness, and professionalism in terms of enforcement and other related workflows. I was responsible for carrying out other key policy operations functions, worked cross functionally to assist in training and support other teams within policy enforcement, and collaborated with other team members to drive impactful improvements to the team's processes and tools.
901 S. Mopac Expressway, Austin TX 78746
Behavioral Health/Data Entry Specialist
04/2017 to 09/2017
Processed behavioral health authorizations, verified patient/member Medicaid coverage, accurately entered provider plan information into database. processed authorization requests by utilization multiple systems and programs. Utilized document management and imaging tools to review medical files, researched and reviewed detailed information within medical records to make determinations. Navigated multiple programs and various applications Made outreach to Medical Providers when necessary
NGA Human Resources
810 Hesters Crossing, Round Rock TX 78681
07/2013 to 03/2017
● Assessed State of Texas Health and Human Services (company client) policies and procedures pertaining to Recruitment and Selection of applicants and advised State of Texas hiring staff on applying these policies and procedures to their specific situation
● Supported state hiring managers and presented clear, concise resolutions to aide in formulating correct assessment criteria to screening applications; advised state hiring managers on the appropriate use of interview questions. Carefully reviewed and approved job requisitions which were posted on state job portal.
● Responded effectively both orally and in writing to inquiries from state hiring managers and human resources staff on recruitment and selection of new hires and rehires. Prepared status reports to accurately identify late applications, late requisitions, notices of posting to close other documents pertaining to recruitment and selection process.
● Successfully developed applicant flow for state positions by placing advertisements in appropriate newspapers, websites, trade journals, and other publications; coordinated college recruiting events and career fairs
● Accurately submitted documentation required to run criminal background checks on all new hires and rehires utilizing secure online resources. Benefits Advisor
03/09 to 07/13
● Successfully and accurately enrolled large numbers of new hire and rehire benefits, tracked and input changes in job status and termination of employees using PeopleSoft (HRMS) and Employee Retirement System of Texas online secure system.
● Utilized critical thinking skills to assess, analyze and resolve benefit cases involving employee benefits in line with the departmental service level agreements.
● Ensured all assigned cases were quickly resolved and all actions were documented to agreed standards (email, telephone, fax) using client specific issue tracking system.
● Worked closely with client employees, managers and job requisition coordinators as well as Employees Retirement System staff to quickly resolve conflicts involving benefits and payroll deductions. Collaborated with payroll department to assist in refunds or collections of premiums in line with payroll calendar.
● Coordinated with reconciliation team as a point of contact for employee payroll queries to accurately identify benefit and payroll impacting issues for client employees and followed and monitored state compliance to meet and exceed Service Level Agreements.
● Counseled and advised client employees and recruiters and hiring managers in respect of state policy and procedures.
Resolution Specialist II
10/07 to 03/09
● Greeted clients in a courteous, friendly professional manner after carefully verifying identity according to policy. Accurately ensured that each call was recorded in Issue Tracking System. Effectively transferred customer’s specific requests to appropriate party and created detailed and concise case notes to be worked by offline team.
● Implemented superior listening skills to fully communicate callers understanding of the solutions that I provided, also effectively directed callers to additional education and information sources that were available online.
● Analyzed and resolved problems which required strong conceptual thinking, while sustaining excellent call handling time, meeting or exceeding S.L.A’s. SUMMARY
I have over 13 years total experience working in customer service, order entry and data entry, have used multi-line telephone systems. I am proficient in Microsoft Word, Excel and Outlook as well as Adobe, Rightfax and am quick to adapt and learn any software. I can type over 45 words per minute,
Parkland College, Champaign IL
Mass Communications Visual Arts
Honors: Dean’s List 1991, 1992