Health Insurance, Account Management, Customer Service
Resume:
Cherlyn Van Der Weele
Objective
Looking for a position in the Health Care Industry using service excellence, senior level experience and managed care knowledge to provide support and leadership in a professional and practiced manner
Accomplishments
Ten years of health care experience in the areas of Commercial, Medicaid and Medicare.
Three years of Sales support in the area of Commercial Mid and Large Markets.
Superior knowledge of the Commercial Products: HMO, PPO, POS, HRA/HSA and ASO/Stoploss.
Experience with Life, Accident and Disability Products.
Exceptional written and verbal communication skills.
Five years of dedicated service in a Commercial Health Insurance call center.
Supervisory and Team Lead Experience for a Commercial Insurance Carrier.
Identified and resolved escalated issues for Clients and their employees.
Implementation experience for both Large and Small Client sizes.
Pennsylvania State Accident and Health Licensing.
Professional Experience
Luttner Financial Group, LTD
Account Executive – Employer Group Benefits – January 2015 - Current
Single handedly provided Service Support to Clients as well as their Staff.
Created Renewal Presentations, selecting plan options and indicating cost savings.
Organized, uploaded and managed client documentation which included enrollments, problem resolution documents and rate information.
Assisted my superior with day to day office support which included taking messages, returning phone calls, managing emails and assisting with scheduling.
Ordered and stocked the office supplies on a weekly basis to ensure all staff had what they needed to complete their job functions.
Attended meetings with Clients for the purposes of open enrollment, plan review during renewal periods and adjust services offered to meet business needs.
Handled potential new client presentations and meetings to review what benefit options were available, services that would be provided and also to ensure the new business was obtained.
Henderson Brothers, Inc.
Account Analyst – Benefits – June 2014 to September 2014
Provided Service Support to Clients and their Staff.
Prepared Renewal Presentations, showcasing plan options and cost savings.
Attended Client Open Enrollment meetings, representing the company as well as answering Employee questions.
AUL - OneAmerica
Sales Support Administrator, SR. – April 2014 to June 2014
Provided Service Support to Sales Associates.
Processed RFP’s, requesting additional documentation from Brokers as necessary.
Answered Client inquiries, provided Certificates of Coverage, and supplied Renewal increases.
Performed administrative duties such as filing, answering phone calls, dictating emails to Clients, and problem solving incoming Client concerns.
UPMC Health Plan
Associate Sales Executive, Mid/Large Market – Sales Support & Administration – October 2011 to March 2014
Processed Requests for Proposals (RFP) – which includes identifying missing information and preparing the data for underwriting submission.
Partnered with Communications and Marketing to produce customized Proposals for Large/Key groups. Led coordination with Communications and Marketing to simplify presentation/proposal process and materials for Sales Executive to utilize in employer and member meetings.
Interacted daily with Producer’s to answer questions as well as address concerns they may have over Proposal’s and Sold Cases.
Assisted Sales Executives with RFP Submission, Underwriting Inquiries, Proposal Release, Sold Case Processing, Group Implementation, Producer Inquiries, and Open Enrollment Meetings. As well as printing and organizing presentations and open enrollment kits.
Internal liaison for all new group implementation from set-up through first 30 days of enrollment to transition to Account Management team.
Responsible for sending weekly updates to Senior Management on the status of prospects and new group implementation.
Lead Provider Analyst – Provider Services – Call Center, March 2010 to October 2011
Supervised 10 to 15 Provider Service Advocates.
Composed annual employee reviews and merit increases.
Worked directly with provider billing representatives to report and resolve claim denial issues.
Managed incoming call queues and staffed lines according to daily needs.
Identified trends to determine the underlying cause(s) behind call volume fluctuations.
Collaborated with senior management to improve call stats, customer experience and issue resolution.
Team Lead – TPA Claims, February 2010 to October 2010
Lead for 5 to 10 Claim adjusters.
Reviewed and relayed quality audit results.
Maintained a positive and upbeat attitude to support my team.
Learned a new product within the first 3 months of the position.
Customer Service Analyst – Commercial Member Services, December 2005 to February 2010
Single handedly maintained all Account Management requests: including claim adjustments, provider/member outreaching, and benefit reviews.
Trended call volumes on a group by group basis, using MC400 report systems.
Trained and assisted the entire Commercial Member Service team with various questions, dedicated lines and new products.
Adjusted and keyed urgent claims.
Created and maintained training documents.
Qualicare Home Medical
DME Sales Coordinator, June 2003 to November 2005
Managed orders received from physician and sleep center offices.
Verified insurance coverage and benefits.
Handled patient calls and directed any necessary follow-up with respiratory therapists.
Sent invoices to billing center.
Handled administrative duties.
Honors
Superstar Award Recipient 4th Quarter 2013 - UPMC Health Plan
Programming and Software Skills
All Microsoft Products, Adobe, and Outlook.
Proficient typing skills, average of 70 WPM.
References
Stephany Hartstirn, Director of Sales Support & Administration, UPMC Health Plan 412-***-****
Jessica Vento Hutchison, Sales Executive, UPMC Health Plan 412-***-****
Christy Boehm, Director of Operations, Builders Exchange Benefits, inc.
412-***-**** x 401
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