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Human Resources, Customer Service, Insurance

Location:
Madison, WI
Posted:
August 04, 2015

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Resume:

Susan J. Atkinson

** ********** ******

Lodi, WI 53555

acq3b1@r.postjobfree.com

Cell: 608-***-****

Dedicated safety administrator with 12 years of experience advancing the safety department for a nationwide electrical and mechanical contractor. Maintained exceptional customer satisfaction results while completing multiple projects simultaneously and improving the turnaround time of programs with little supervision. Achieve proven critical thinking experience while exercising discretion and maintaining confidentiality.

Respected lead claims processing specialist emphasizing in customer service; instill a shared, enthusiastic commitment to customer service to achieve company goals. Lead by example and ensure the execution of all company policies while emphasizing continued knowledge improvement and training. Areas of Expertise

Customer Service Management

Benefits Administration

Complaint Handling & Resolution

Claims Investigation/Processing

Mediation & Litigation

Working Independently

Professional Experience

HOOPER CORPORATION Madison, WI 2003 TO 2015

Human Resources Assistant / Claims Administrator

Facilitate medical, dental and flexible spending account benefits advising and educating employees on available benefits. Identify employees eligible for COBRA and administer benefits. Conduct new hire orientations collecting all necessary paperwork, update employee records in HRIS database. Generate programs for employees who required disciplinary action and substance abuse treatment. Responsible for processing all self-funded worker’s compensation claims, general liability claims, automobile claims, vandalism claims, and theft claims up to

$100,000.00. Analyze, research, and resolve incoming verbal inquiries and correspondence in a professional and timely manner. Assist insurance adjusters, nurse case managers, onsite nurses, physicians, therapists, private investigators, paralegals and attorneys in coordinating proper claims handling and managing litigation. Selected Contributions:

Directed insurance benefit eligibility, aided union members with smooth transition of benefit continuation, provided support to employees for all benefit questions, executed flexible spending payments.

Completed orientation of new employees, verified completion of required paperwork, secured copies of training records, updated records in database, stored all department records, keeping confidential forms secure.

Created and implemented new software program for managing claims, generating reports and spreadsheets for management.

Administered safety program across all divisions and for all employees (500+). Implemented safety award program with an outside vendor for a positive evolution. HUMANA INSURANCE Madison, WI 1989 to 2003

Lead Claims Processing Specialist, 1996 to 2003

Benefit Analyst, 1989 to 1996

Responsible for processing high dollar group medical claims, reviewing incoming and outgoing correspondence, auditing associates work performance, handling incoming and outgoing verbal inquiries, coaching and developing associates, assisting supervisor as needed. Analyze, research, and resolve incoming verbal inquiries and correspondence in a professional and timely manner. Selected Contributions:

Instrumental in providing technical support to fifteen associates to help resolve customer challenges and assist associates to gain knowledge for meeting corporate standards.

Particularly effective in timely and accurate processing of group medical claims up to $20,000.00.

Trained, educated, and managed the outsourcing of group medical claims to 35 temporary employees.

Actively identified and communicated best-known methods that improved quality and productivity within the section/division.

Education and Training

CAPELLA UNIVERSITY Redwood Falls, CA 2002 TO 2003 Earned 15 credits; concentration in business studies NATIONAL ASSOCIATION OF STATE BOARD OF ACCOUNTANCY (NASBA) – Nashville, TN 2003 Earned 11 credits; concentration in business studies NATIONAL WORKER’S COMP & DISABILITY CONFERENCE – Las Vegas, NV 2010 to 2014



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