Insurance Sales Managed Care
Resume:
Davis Professional Resume...
Shatoya Davis
visshatoya.: mail.com
Professional Profile .
* 10+ Years’ Professional Healthcare Experience * Managed Care and Pharmacy Experience
* High Volume of Calls * Texas Life, Accident, Health, & HMO License #: 1920520 + Insurance Sales,
Insurance Authorization + Prior Authorizations, EOBs, Eligibility, Enrollment + Claims,
Appeals, Billing * Medicare, Medicaid, HIPPA + Proficiency in Microsoft Office Suite * Extensive HRIS
experience (Workday, Dayforce, ADP, Ultipro, etc).
Professional Experience
Builders FirstSource, Inc. Dallas, TX
October 2021 — Current
HR Benefits Analyst
Ensure accurate and timely benefit auditing and reporting
Directly report any auditing and/or software configuration issues to Management
Assign work task and tickets to the appropriate party for processing
Assist with Vendor billing and payment request
Process Life Claims and Beneficiary Outreaches
Update Plan Guides and Intranet to ensure the most up to date information is available to team
members
Benefit Census Report
Assist with Onboarding for New Hires and Acquisitions
OneSource Virtual, Inc Irving, TX
June 2018 — October 2021
Sr. Benefit Specialist
* Heavy Reporting
* Workday HRIS experience - auditing to ensure HRIS and vendor information is up to date
and well managed
Workday Enrollment / Open Enrollment and Life Events
Outreach to New Hires and employees requesting benefit changes
Process Dependent Audits by reviewing employee submitted documents and making
outreaches
Processed Monthly Workday Termination Reports, Weekly BPAT reports, Carrier Error
Reports
Death Claims, Workers Comp Claims & Medical Support Orders
Lockton
August 2017 — June 2018
Benefit specialist
+ Process IRS Qualifying Life Events and review supporting documentation to ensure
document is sufficient.
* Assist employees with new hire and annual enrollment submissions
+ Educate employees on enrollment guidelines & restrictions
* Follow-up with employees to ensure enrollment & documentation is received by the
deadline.
* Follow-up with clients to ensure timely resolution to employee issues
* Communicate with carriers to assist with eligibility updates, employee claim issues, ID card
request, etc.
* Compose Benefit Packets.
* process benefit payments
* research claims to ensure payments are received in a timely manner and to ensure claims
are paid correctly based on plan benefits
Optum (Different Contracts) Richardson, TX
November 2012 — June 2017
March 2015 — June 2017
Customer Service Representative (United Healthcare Campaign)
* Handle up to 75 inbound and outbound calls regarding insurance authorization, benefits, and
claims ED
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