Kimberly MacQuesten

** ******* ******* #**, ********, NJ 07836

acz69z@r.postjobfree.com

Employee Benefit Specialist

SUMMARY

** *****’ experience as Licensed Employee Benefit Specialist

Administer group plans with 5000 active and retired employees in multiple states

Review, extract and analyze claims data

Negotiate rates, request alternate plan designs

Conduct open enrollment meetings

Communicate plan changes

Identify, research and resolve employee issues

Review and submit data to carriers

COBRA and FMLA

Reconcile eligibility and billing

Review SPD and contracts for accuracy

Ensure compliancy with state and federal regulations

Excellent oral and written communication skills

Develop strong personal and trusted relationships

WORK EXPERIENCE

A. J. Gallagher

Account Consultant 2016- Present

Consult clients with 10-100 employees representing $500,000 in revenue by strategizing long term benefit goals while maintaining a generous benefit portfolio by utilizing various funding options. Marketed lines of business to support rate passes ensuring client loyalty.

Leveraged customer rapport by suggesting A. J. Gallagher fund COBRA administration thus demonstrating partnership resulting in successfully retaining a valuable large group. Proactively assesses, clarifies, and validates client needs by aligning their valuable benefits dollars with the financial needs and wants of their employees by focusing on programs that manage risk rather than chase costs.

Establishes productive, professional relationships with various A. J. Gallagher Sales units by driving potential sales opportunities when opportunities are apparent. Meets assigned performance goals by successfully obtaining referrals for new business and cross selling which leads to organic growth.

Possesses strong analytical background with working knowledge of pricing concepts. Recognizes clients’ network utilization and explained Medicare reimbursement methodologies to satisfy the needs of highly compensated employees.

Automatic Data Processing Insurance Agency

Executive Client Manager 2014-2016

Managed a book of business of over 300 small group employers which equaled over $7 million dollars in premium and over $300,000 in commission. Maintained above 85% retention rate due to client relationship, time management and organizational skills.

Offered strategic consultation rather than carrier placement. Preemptive questioning results in a positive renewal approach. Created customized benefit packages and contribution strategy by marketing, analyzing and presenting competitive quotes based on client’s needs. Suggested cost effective alternative plan options including tax advantage HSA, FSA and POP plans.

Prepared payroll deduction spreadsheet based on employer contribution. Liaised with different departments such as payroll, tax advisors, workers’ compensation, POP, COBRA and FSA units to assure plan is serviced as expected. Conferred with management to make necessary changes as needed.

Recognized clients’ non-compliancy and assisted in modifying practices to avoid potential fines. Offered guidance in COBRA and state continuation regulations. Keep clients abreast of Affordable Care Act regulations by attending seminars and routinely reviewing appropriate websites such as Eye on Washington.

Designed an Excel spreadsheet to track connections with customers to assist in cultivating relationships and encouraging retention. Excel spreadsheet was incorporated into all client managers’ day to day activities and monitored by management.

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Kimberly MacQuesten acz69z@r.postjobfree.com 973-***-****

Mentored associate client managers with the necessary knowledge of products and carrier underwriting guidelines to guarantee work is accurate and beneficial to the client.

Prescription Corporation of America

Field Services Manager/Agent 2012-2013

Account manager for public and private entities in the role as an insurance agent. Responsible for keeping clients abreast of trends in prescription drug costs. Cultivated relationships with monthly site visits. Organized and presented open enrollment meetings at various sites within the state of New Jersey.

Privy to the process of a mail order drug facility; conducted client visits confirming the security of a start-up business.

Developed a procedure to identify users of non-formulary and brand-name drugs; prepared mailing addressed to members encouraging the use a formulary or generic alternatives.

Fairview Insurance Associate Agency

Broker/Account Manager 2007-2012

Responsible for managing a book of New Jersey Public Entities consisting of active and retiree population ranging from 200-5000 active and retirees. Also, responsible for a book of 50 small employer groups.

Experienced in enforcing same as or better than policies. Analyzed claims data to identify the solvency of leaving the state plan. Assisted management in marketing plans utilizing carrier relationships to negotiate rates. Responsible for communicating plan changes and options to active employees, retirees and COBRA recipients.

Coordinated open enrollment meetings for Public Entitles including synchronizing multiple carrier attendance. Created communication material ensuring retirees and COBRA participants were privy to same. Assured space availability adhering to time allotment due to shift changes. Arranged wellness activities to boost attendance.

Initiated invoice reconciliation and identified possible illegitimate enrollees; advised and encouraged state statute enrollment regulations. Audited records against various databases to maintain accuracy. Assisted in resolving client and carrier accounting issues, including negotiating discovered discrepancies.

Reviewed SPDs, contracts and plan set up to ensure compliancy. Answered plan interpretation, client policy and coverage questions based on industry and carrier nuances in comparison with other Public Entities.

Bankers Life and Casualty

Independent Sales Consultant 2005-2007

Focused on the needs of the retirement market through a broad portfolio of life and health insurance retirement products. Offered Medicare supplement and Medicare part D plans and Medicare Advantage plans based on health demands and financial stability. Obtained LTC certification; focused on aging in place as key selling point.

Responsible for creating leads; developed a network of referrals by building strong relationships with excellent listening skills and personal contact. Liaised with family members to assist in the decision process.

Recipient of successful new agent awarded for exceeding expected commitments.

Singer Nelson Charlmers

Broker /Key Account Manager 2003-2005

Serviced a comprehensive book of business with all lines of health insurance with companies of 50-500 employees. Managed the renewal/marketing process; coordinated the implementation of new plans and/or the continuation of current plans and contract changes. Responsible for after-sale policy administration confirming contractual obligations were met.

Successfully acted as employee advocate by appealing adverse claims decisions with the insurance company and appealing to the Division of Banking and Insurance with positive outcomes.

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Kimberly MacQuesten acz69z@r.postjobfree.com 973-***-****

Prudential Insurance Company of America/ Aetna Life Insurance Company 1989-2003

National Accounts Operations

National Account Manager 1993-2003

Suggested and implemented a passive PPO dental plan resulting in a $1 million annual savings.

Organized client meetings including underwriters, marketing and dedicated claims managers on a quarterly basis solidifying client/carrier partnership.

Conceptualized savings in claims determination driving positive actions. Presented underwriting briefs predicated on client’s position.

National Accounts Managed Care Specialist 1990-1993

Supported National Account Executives by monitoring activity in national service areas. Subject matter expert in variations of state mandates. Responsible for identifying market fluctuations and composing communication for distribution to affected employees.

Attended open enrollment meetings at national clients’ multiple locations driving membership by establishing personal relationships with local Human Resources team and their employees.

National Accounts Billing and Eligibility Coordinator 1989-1990

Audited national account’s monthly billing and eligibility; responsible for booking and allocating premium payments. Direct contact with clients regarding discrepancies.

Generated reports for upper management with responsibility for gathering delinquent account ledgers for monthly forecasting meetings.

EDUCATION

County College of Morris County, Randolph, NJ

University of Maryland, Baltimore County (UMBC), Baltimore, Maryland

Bachelors of Science (BS)

ADDITIONAL IT SKILLS

Proficient in Microsoft Office (Word, Excel, Power Point, Adobe, Publisher, Outlook), Agency Management System (Applied, TAM, Vision, AOS and QBMS)

CREDENTIALS

New Jersey Life and Health Insurance Producer, License #9617107

Non-resident license in CT, MD, NY, OH, PA and the District of Washington

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