MARIA E. WILLIAMS, MSW, ACS

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

Kennesaw, Georgia 30152

404-***-****

acv9km@r.postjobfree.com

EDUCATION

University of Florida

Hough Graduate School of Business/Warrington College of Business Administration Awarded August 2011

Master in Business Management: Concentration in Healthcare Risk Management

GPA. 3.4

Classes: Economics of Business Decisions Health Care Risk Mgmt.

Financial and Managerial Accounting, Quality Improvement and Compliance

Organizational Behavior Law and Healthcare

Managerial Statistics Risk Management and Liability

Financial Management Evaluation of Risk Management

Marketing

Florida State University

Master of Clinical Social Work, Advanced Standing Program, GPA: 3.6 Awarded Dec 1997

Bachelor of Science in Social Work, Overall GPA: 3.2 Major GPA: 3.8 Awarded Dec 1996

LICENSES:

Life, Accident and Sickness, Annuities Agent Awarded 2007

PROFESSIONAL EXPERIENCE

Underwriting Consultant (Self-employed Contractor, Remote Underwriter) 1/2007Present

Contracting Companies/Underwriting of Policies: Minnesota Life, AIG, IBU, Prudential, Risk, Fidelity Life, Lloyds of London,

Aetna, EMSI, F orresters, MediSummary. Underwriting new business and assess risk based on medical records, financial returns,

and company guidelines. Leads the implementation process by participating in pre and post implementation meetings. Manage

large caseload and audit individual new business and renewals. Products include medical, short and long

term disability, long term care, term life, universal life, and life settlement risks and all associated riders: AD&D,

accident medical, critical Illness. Performs risk assessments of junior underwriters including MIB reviews, provides

recommendations and training feedback to underwriting director. Work with reinsurance p ersonnel t o determine

r isk tolerance and acceptance. Evaluates underwriting requirements depending upon the product and cross reference

with reinsurance company manual and guidelines. Collaborate with external and internal customers to analyze

information needs. Provided new system training for staff and ongoing customer s upport and liaison between the

client underwriting business units, technology teams, and support teams. Achievements: Promoted from Underwriter

to Sr. Underwriter, and to Underwriting Consultant. Mentor and cosigner for 8 years. Approval level of

IDI $20,000/mo., BOE $ 30,000/mo, B uy-Sell $500,000 and Life 3 million.

Senior Claims Analyst MetLife, Atlanta, Georgia 10/20072/2010

Work closely with employers, nurses, and physicians on key accounts to ensure appropriate administration

of policies. Lead implementation process. Responsible for auditing and review of complaints/issues regarding

the evaluation of claims to include interpretation of contract provisions, financial and policy analysis, and

review of medical records to determine claim direction is accurately followed and correct decisions made on

cases. Also, determine if the calculation of claim benefit amounts were correctly performed and application

of policy provisions and offsets appropriately to ensure client satisfaction and enhance overall experience.

Assist with monitoring programs to reduce company liability and policyholder premiums at renewal. Provides

historical information required to complete renewal underwriting. Provides financial reports to the

customer unit by providing data for quarterly strategic measurement reporting maintains comprehensive

files in compliance with company policy provides guidance and consultation on standard and ad hoc customer reports

completes internal financial performance guarantee liability report prepares policyholder liability statements. Develop

system and operational workflows and requirements for claims operations. Work closely with reinsurance.

Achievements: Selected to handle performance guarantee clients and Mid/Large Accounts with

over 10,000 Employees.

Implementation Coordinator II, Wellpoint/Anthem Life, Atlanta, Georgia 2/200612/2006

Work closely with employers, policyholders, sales representatives, account managers, brokers, and specialty sales

managers to ensure customer satisfaction. Based on feedback develop training manual and implement training

workshops needed based on interviews, reviews and audits conducted. Review new sold life and disability accounts

and audit for accuracy. Works with account team to manage customer relationships and satisfaction. Provides

financial support to the Request for Proposal (RFP) process by participating in initial strategy meetings and ongoing

sales strategy meetings responds to questions arising from RFP. Provides financial support

during the implementation process by participating in pre and post implementation meetings participates in

audit and review of performance guarantees partners with administration team to prepare and finalize

requirements for claims, billing, and banking structure. Implement processes and workflow charts. Process

amendments to policy provisions determined to be inaccurate at claim time. Assist with company

integration projects for the entire East Region integration team, which consists of migrating s even states in

regards to workflow, systems, and resources. Recruit and train new and existing employees on team based on

audit results. Work with customer financial accounting and projections accounting, billing and banking

reconciliation. Ensure all cases and claims meet reinsurance guidelines.

Achievements: Integration Project Award for Blue Cross Blue Shield/Anthem Life merger. Team Lead for

implementation system conversion team and trained staff on new systems.

Underwriter/Sr. Claims Specialist, Munich American Reassurance Company, Atlanta, Georgia 9/200010/2005

Perform internal and external audits of reinsured cases to ensure client insurance companies are

following the underwriting guidelines and client treaty. Evaluate decisions were accurately made on approvals, denials,

and claim benefit amounts. Provide audit results and recommendations to client executive management. Provide training

to client insurance companies regarding the decisions, n ew policy/product research, claim business practices, and

mortality trends. Perform onsite evaluations of client insurance companies policies, software and imaging systems, and

claim procedures and report results to Internal Executive Committee and TPAs. Assist in composing new contract

language, analysis of disability forms, claim/underwriting guidelines, and technical applications. Act as liaison for

clients and their employees and provide informational workshops to client companies regarding improving workflows,

caseloads, and turn around time standards. Perform financial risk assessments by evaluating tax returns to determine

accurate policy and benefit levels and business valuation of profit and loss statements. Comply with HIPPA, GLB, and

MIB Guidelines.

Achievements: Passed ARA 440 and FLMI 301, and assisted in textbook revision of LOMA ACS course.

Promoted to Underwriter from Senior Claims Specialist. Participated on project team for development of new

claims system, developed client rating and quarterly reports, responsible for implementation of electronic

submissions from clients, selected to represent company in Munich, Germany.

Claims Specialist, Canada Life Assurance Company, Atlanta, Georgia 11/19989/2000

Conducted interviews and assessments with policyholders and claimants regarding disability claims and

Reviewing medical records in determining disability eligibility. Produced solid claim decisions for long

term disability, vocational rehabilitation medical, and social security referrals. Reviewed approvals, denials, and

appeals of new employees and examiners on team and reported results on job evaluations for team members.

Recovered overpayments and investigated cases for fraud. Assisted with negotiation of settlements with respect to

claim reserves. Coordinated visitation program, which educated claimants on the adjudication process and

provided direct contact with policyholders, sales agents, and claimants. Participated on Crown Life acquisition

team and provided audit of disability claims and systems prior to acquisition. Provided new claim system training for

staff. Understanding of underwriting, actuary, TPA, vendor contract agreements, and compliance issues with respect to

disability policies.

Achievements: Received LOMA ACS Designation, developed new claim file system, assisted with due diligence and

coordinated acquisition of Crown Life for disability claims department, and assisted in conversion of JAS disability

claim system from Crown Life.

Medical Disability Examiner, Department of Labor and Employment Security, Tallahassee, Florida. 1/199711/1998

Investigated initial and reconsideration social security disability claims by evaluating medical records, job descriptions

and analysis, and interviewing claimants and physicians. Conducted mental status examinations and psychosocial

assessments. Provided referrals to vocational rehabilitation and other community resources. Mentored new employees

on team and assisted with caseload and training. Understanding of medical terminology and ICD9

Codes.

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