Resolution Specialist Project Coordinator

TJ Ross

Euless, TX

Cell: 682-***-****

****************@*******.***

I possess significant experience in various facets of business to propel my team and ultimately the company to the next level. A strong desire to advance my career within the industry drives me to provide the highest quality of service to internal and external stakeholders. Summary of Qualifications:

● Licensed Life and Health Insurance Agent in all 50 states and DC

● Supervising, training, coaching & mentoring

● Processed health and welfare benefits enrollments

● Identified opportunities to improve business processes

● Strong analytical and technical problem solving skills

● Proven track record in managing project schedules and resolving conflicts

● Proficient in Word, Excel, PowerPoint and SharePoint applications

● Effective listening and reading comprehension skills EMPLOYMENT:

Mercer (Marsh and McLennan Companies)

08/2018 – 6/2021

Benefits Consultant/Project Manager

• Answers, documents, research, and monitors employee calls, emails/transactions for case resolution.

• Documents client issues and escalates issues to appropriate support team to resolve.

• Managed Leave of absence, Short Term Disability, FMLA, and Paid Family cases and provided support to other teammates as a subject matter expert.

• Oversees status changes related to COBRA updates

• Assists pre and post 65 callers with enrollment process and questions to achieve sales targets.

• Responds to both standard and more difficult customer inquiries regarding products.

• Explains all aspects of benefits offerings including processing qualifying life events, dependent verifications, and submitting appeals/exception requests.

• Researches to respond to customer inquiries, and responds formally to correspondence, either verbally or in writing, utilizing all reference material necessary to provide an informed response to the customer.

• Requests additional/missing information from the customer via letter or telephone call to answer customer inquiries.

• Delivers expert level mentorship and support on mid to large scale multifaceted projects guiding/directing stakeholders and colleagues within various business units/departments.

• Oversees tracking and reporting for multiple project initiatives from inception to completion of the full project life cycle then presenting to stakeholders.

• Provides written and verbal feedback to internal/external stakeholders and colleagues using professional and/or layman terminology.

• Assists with New Hire benefit elections and Annual Open Enrollment events

• Completes carrier benefit audits and correcting benefit statements Independent Licensed Life and Health Agent

9/01/2015 – 08/06/2018

● Sold life, health, and supplemental insurance products to prospects across the nation. Optum Health

09/29/2014 – 09/01/2015

Medicaid Client Advocate

● Obtained Texas Life and Health License

● Provided objective information regarding how to obtain Medicaid coverage.

● Answered inquiries from prospective and existing members related to the Medicaid enrollment process, eligibility status/issues, and benefit levels.

American Cybersystems (ACS)

04/30/2012- 04/01/2014

HR Analyst/Project Manager

● Answered complex benefits and HR policy and procedure questions.

● Processed Unemployment Claim disputes from inception to completion.

● Strong understanding of short term and state disability procedures.

● Initiated Leave of Absence (FMLA) requests.

● Processed transactions by collecting required information or backup documentation.

● Coordinates with project stakeholders, colleagues, and users to ascertain program scope and focus

● Collaborated with business clients/project sponsors and various subject matter experts in developing and monitoring project goals.

● Interfaced with Leads, Managers, Payroll, and HR Business Partners to resolve escalated issues.

● Answered incoming requests via telephone, internet, and/or correspondence from associates.

● Resolved customer requests/issues by researching and taking additional steps as required. Fast Debt Solutions

01/2005 - 2/2012

HR/Project Manager

● Coordinated benefits enrollment.

● Processed payroll reports via SAP/CATS.

● Responded to unemployment claim inquiries.

● Documented settlements and cases in Salesforce.

● Initiated FMLA/Short Term and State disability claims.

● Gathered employee census data for electronic submission.

● Prepared on-boarding materials and set up benefits for new hires.

● Assisted with timecard and accrued time off inquiries and adjustments.

● Processed payroll and assisted with timecard and paycheck corrections.

● Assisted with Talent Acquisition process and Performance Reviews via Taleo.

● Supported a portfolio of 400+ clients assisting with concerns related to their debt.

● Reset passwords for clients’ GCS account and assisted with helpdesk troubleshooting.

● Sales- pitched potential clients on the benefits of the program and enrolled new accounts.

● Negotiated settlements and setup lump sum settlements using the clients’ GCS savings account.

● Established a team of associates and oversaw various HR projects from inception to completion

● Reviewed accounts weekly to ensure that representatives contacted clients with past due balances

● Coordinated annual and ongoing eligibility/enrollment for client’s health and welfare benefit programs

● Managed all aspects of various project initiatives from requirement implementation, planning, scheduling and providing cost estimates, overseeing processes and utilization of tools, delegating and guiding project colleagues through completion.

Caremark

Richardson TX

3/2002-1/2005

Senior Resolution Specialist (Team Lead/Project Coordinator)

● Claims processing and billing.

● Password resets and troubleshooting.

● Performed user acceptance testing and ran SQL queries.

● Supported escalated accounts as a form a service recovery.

● Identified and documented defects and using defect-tracking system.

● Provide customer with physician referral & credentialing information.

● Mentored new advisors with immediate translation of benefit parameters.

● Created a quick reference guide to assist new hires and seasoned advisors.

● Forwarded complex benefit inquiries to internal support teams for correction.

● Processed claims and transactions using AS400, Siebel (Stars), and PeopleSoft systems.

● Acted as project coordinator assisting project managers with multiple facets of the project life cycle such as planning/scheduling, tasks assignment, interfaced with project staff to document progress and monitor deadlines, supported scope development

Education:

Franklin D Roosevelt

Diploma- May 1994

Texas Woman’s University

Dental Hygiene 1998

ITT Technical Institute

Information Systems Administration 2016

License:

Texas Life and Health Agent # 2001592 (licensed in all 50 states and DC) AHIP Certification

Key Skills: PeopleSoft, Taleo, SalesForce, CATS, SAP, FMLA Benefit Tracker, AS400, Microsoft Office Suite, ADP, Exponent, Benefitsolver, UltiPro, Empyrean

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