Employee Benefits Sales, Service and program administration
Resume:
Lore D. Graham
Delaware, Ohio 43015
*****@***.***
Qualification Profile
. Highly accomplished, results oriented Employee Benefits Manager and
Insurance Sales and Service Account Manager with extensive experience in
sales, service, account retention, planning, implementation and
administration of cost effective and competitive health and welfare
benefit programs.
. Proficient in employee benefits plan design and analysis, bid
preparation, request
for proposal evaluation, program implementation, contract
negotiation, contract
performance and compliance.
. Wide knowledge of state and federal laws of the employee benefits
program.
. Proven success in exceeding sales goals, and vendor and client
relationship
through high client retention and satisfaction levels.
. Flexible team player and proven achiever with a strong work ethic and
drive to
succeed.
. Extremely motivated to excel and contribute to the success of any
organization.
Core Competencies
. Strategic and Consultative Sales . Account Management . Project
Management .
. Operations Management . Benefit Plan Design . Funding Arrangements .
. Negotiation . Account Reporting . Benefit Communications . Operations
and
. Claims Audits .Employee Benefits Enrollment Process and Reconciliation .
Claims Appeals . Customer Service . Regulatory and Compliance
. ERISA, COBRA, HIPPA, FSA and ACA .Word, Excel, PowerPoint, Outlook and
PeopleSoft
Senior Account Representative
Anthem (2013 - present)
. Serve as primary client contact and liaison between client and internal
departments.
. Ensure new benefits programs sold are implemented and administered
properly.
. Manage wellness programs and coordinate health fairs.
. Coordinate annual open enrollment.
. Demonstrate walk-through of client, broker and member portals.
. Resolution of escalated claims, membership and system access issues.
. Request, review and deliver various claims, membership and billing
reports.
. Reconcile employee enrollment and benefits selections.
Benefits Manager
State of Ohio (2004 - 2013)
. Served as third party vendor liaison for health and welfare plans.
. Administered COBRA, dental, vision, life, FSA and long-term care.
. Managed a Benefits Analyst with direct report responsibility.
. Prepared bid specifications and led request for proposal and vendor
evaluation in
collaboration with benefits consulting firm and procurement
personnel.
. Coordinated, monitored and evaluated contractor performance of employee
benefits programs.
. Established rate setting.
. Negotiated benefit program renewal.
. Ensured all benefit plans, policies and programs were in compliance with
federal
and state legislation.
. Created benefits communication materials.
. Reviewed periodic data for program design improvements and vendor
contract
compliance.
. Prepared reports cost and benefit analysis.
. Generated vendor billing invoices under a self-bill arrangement.
. Managed daily administrative duties including medical premium payments,
appeals, exempt employee life insurance claims certification and problem
resolution.
. Investigated legal and legislative actions which may impact the plan;
update
contract language as appropriate.
. Trained agency benefits specialist on PeopleSoft HCM module.
Insurance Agent
Secure Choices (1999-2004)
. Acquired new business revenue and increased existing business revenue
through
quotes, leads and referrals.
. Exceeded revenue targets by maintaining existing business and increasing
volume
by 30%.
. Actively managed accounts including resolving elevated claim and premium
payment issues.
Key Account Manager
United Healthcare of Ohio (1996-1998)
. Handled all aspects of self-insured and fully-funded employer group
health account
management successfully.
. Increased retention by meeting client requests in a timely and accurate
manner, thus securing repeat business.
. Successfully negotiated renewal sales with company officials resulting
in 97% retention of major accounts.
Medicare Sales Representative
. Demonstrated expertise in securing substantial enrollment in both
individual and
group markets.
. Coordinated and conducted public meetings for Medicare eligible
individuals and
training sessions for employer group retirees.
. Recognized as top sales representative in the state, averaging 135
individual
monthly sales with a 97% retention level in the first 12 months of
operation.
. Exceeded personal and team new business goals by 20%.
Account Executive
Health First (1995-1996)
. Sold and serviced employer group HMO, life, AD&D, prescription drug,
vision and
dental products.
. Increased product visibility and market share through presentation and
development of four major accounts increasing revenue by 20%.
. Credited with achievements servicing existing accounts to ensure
renewals and
maximize profit potential through sales of ancillary products.
. Demonstrated expertise in new business development, client needs
analysis,
product presentation, suggestive/strategic selling and problem-
solving.
Major Account Executive
Medical Mutual of Ohio (1986 - 1995)
. Managed State of Ohio self-funded medical PPO plan and life plans for
62,000
employees.
. Acted as consultant to employer on plan design and cost for union-
negotiated
health benefits.
. Implemented benefits internally to ensure proper claims adjudication,
monitored
internal performance requirement for contract compliance.
. Worked directly with underwriter to establish rates.
. Recipient of President's Cabinet Award for outstanding service.
Education
. Franklin University, Human Resources Management
. Otterbein University, Business Administration
Licensure
State of Ohio license in Health, Life, AD&D, Variable Annuities, HMO and
Property and Casualty
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