BATON ROUGE, LA *****

225-***-****

ad016l@r.postjobfree.com

JENNIFER O’HARA

SKILLS

Diverse experienced professional background primarily in Health Insurance Management, as well as Restaurant and Customer Service Management. Excellent contract negotiations abilities, alongside provider relationship preservation. EXPERIENCE

Jasmines on the Bayou & Hannah Q Smokehouse; Baton Rouge, LA — Prep and Sous Chef JANUARY 2020 - PRESENT

● Ensuring all tickets are fulfilled in a timely manner according to customer specifications.

● Resolving customer complaints regarding food service.

● QA checks before expediting food orders.

● Handling orders for special catering requests as well as Major Menu orders.

● Controlling inventories of food, equipment, smallware, and reporting shortages to designated personnel.

● Forecasting staff, equipment, and supply requirements based on a master menu.

● Inspecting supplies, equipment, and work areas to ensure efficient service and conformance to regulatory standards.

● Preparing salads, desserts, dressings, sides, assisting the sauté and fry stations with their prep lists when needed, monitoring inventory and proper rotation, and assisting management with order placement when items are needed.

Dina Dental; Baton Rouge, LA — Provider Recruiter and Representative 2014 - 2018

● Scheduling interviews with healthcare providers and potential clients to discuss benefits and costs.

● Overseeing HIPAA and OSHA compliance in participating dental offices.

● Completibg human resources operational requirements by scheduling and assigning employees and new clients onboarding.

● Collecting and analyzing information to monitor compliance outcomes and identifying trends of non-compliant behaviors.

● Coordinating implementation of people-related services, policies, and programs through departmental staff and area locations.

Colonial Life; Baton Rouge, LA — Executive Account Administrator 2012- 2014

● Overseeing enrollment of new employees and company-wide yearly health benefits enrollment period.

● Managing employee benefits, workers’ compensations, health and pensions program plans.

● Contributing to the yearly renegotiation process with clients.

● Sourcing new clients by analyzing businesses as well as rural and urban areas to initiate meetings and negotiations.

● Saving costs by analyzing and modifying compensations and benefits policies to establish competitive programs and ensuring compliance with legal requirements.

● Monitoring data integrity and confidentiality by observing strict regulations and procedures.

● Reviewing employee enrollments to verify accuracy, inputting information to company databases.

● Working with senior management to initiate new projects and accounts; assisting with the various processes of implementation across departments.

Blue Cross and Blue Shield of Louisiana; Baton Rouge, LA — Contracts Administrator JULY 2009 - 2013

● Identifying, analyzing, and researching legal as well as contractual issues to prepare for contract preparations.

● Negotiating legal agreements, drafting alternative language in contracts in order to ensure HIPAA compliance and privacy regulations as well as federal contract regulations.

● Reviewing original, executed contracts while communicating with third-party vendors.

● Performing due-diligence on vendors; including verification of corporate status with the Secretary of State.

● Verifying all RFPs, contracts, schedules, appendices, and related materials were present.

● Keeping abreast of internal, external, legal, and regulatory developments related to work responsibilities to provide company with the best professional assistance.

● Building strategic relationships with key contracts to enable problem-solving and issue resolution.

● Examining performance requirements, milestones, deliverables, including business and legal terms.

● Managing subcontract administration and compliance and coordinated contract closeouts. Joe’s Crab Shack; Baton Rouge, LA — Shift Lead and Trainer FEBRUARY 2012 - SEPTEMBER 2014

● Training new service staff on personal and professional presentation in accordance with restaurant brand guidelines; as well as how to adhere to sales techniques and abilities to properly and enthusiastically promote menu items.

● Delegating tasks to employees and monitored activities start to finish on task completion.

● Complying with company safety procedures, policies, and regulations to promote a safe working environment.

● Leading staff on duties from set-up to tear-down; including opening and closing registers, cleanliness standards.

● Not only meeting, but exceeding required health standards for upkeeping restaurant safety and health guidelines.

● Coordinating shift workers for inventory receiving, auditing, and restocking.

● Applying continuous improvement programs in daily activities to boost productivity, improve quality, and reduce costs.

● Resolving customer complaints and reporting issues to Senior Management when outside job specifications to achieve resolution.

● Achieving highest sales generated which led to promotion to assigned Shift Lead Title and Trainer.

● Handling high priority tables as well as larger parties while also prioritizing other staffing needs and training.

● Successfully expediting and assuring the quality of all assigned orders and specific off menu requests from customers on a regular basis.

Gilsbar; Covington, LA — Contracts & Regulatory Compliance Coordinator, Claims Supervisor JUNE 1999 - MARCH 2004

● Reporting to Legal Counsel on a regular and daily basis to coordinate tasks and job duties.

● Checking and completing regulatory compliance research using both Lexis-Nexis and WestLaw Implementation for auditing of changes.

● Building positive working relationships with other department managers through effective communication.

● Executing successful compliance monitoring and risk assessment programs.

● Conducting research for Plan Document creation, amendment, and administrative (ASO) agreements.

● Consulting and counseling to all areas of the company regarding compliance and procedures.

● Supporting strategic development and objective setting by analyzing audit outcomes and generating actionable recommendations.

● Overseeing renewal of process for 14 fully insured state associations every 6 months.

● Supervising over 25 employees in the Claims Department.

● Training and implementing the responsibilities for understanding preliminary claims data entry, PPO repricing, maintenance of provider records and upkeep of PPO fee schedules. American LIFECARE; New Orleans, LA — Operations Associate MARCH 1996 - JUNE 1999

● Completing contract negotiations with physician provider networks throughout Louisiana.

● Writing data extract programs on internally built systems for client-oriented reporting (ie: statistical claims analysis, network savings, provider utilization, internal productivity, client-provider payment audits, and billing reports)

● Coordinating with clients and group enrollment set-up between all departments as well as clients.

● Problem-solving claims payment issues for providers, payers, and members.

● Supporting multiple departments simultaneously (ie: Claims, Customer Service, Utilization Review, and Provider Relations) while continuing regular and timely communications between all.

● Completing pre-certification of Case Management and Durable Medical Equipment negotiations with vendors effectively.

EDUCATION

University of New Orleans — Bachelor’s Degree

MAY 2009

ACHIEVEMENTS

Created and filed the applications for, then oversaw the acquisition of an Incumbent Workers’ Training Grant worth over

$514K from the State of Louisiana for employee training while in association with Gilsbar. Implemented multiple new claims processing systems during tenure with healthcare industry Shared marketing responsibilities to help transfer new clients’ business which generated in excess of $25K/Monthly for American LifeCare.

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