Julie Jay Weiss 818-***-**** advqb4@r.postjobfree.com

Objective & Skills

Dedicated office professional with over 15 years of experience in the insurance industry. Proficient communicator who successfully leads others and helps resolve problems. Passionate about serving both clients and customers. Able to complete projects on time. Focused on process improvement. Strongly believe in result-oriented teamwork. Enjoy challenging and pushing myself towards new heights in both my career and in life. Understand that work is not just about meeting deadlines, but also about creating a culture, and atmosphere, that is as productive as it is fun.

.

Experience

GRIEVANCE AND APPEALS CASE COORDINATOR HEALTH NET 2017 - 2020

·Maintained assigned Grievance and Appeals (G&A) member case load along with all documentation. Provided needed information in order to resolve all G&A cases for the Department of Health Services audits and compliance. Provided final resolution letters directly to members and stayed within the mandated resolution time frames. Assured compliance with all of Health Net’s policies and all government regulations and laws. High-level customer service, with both members and providers, through in-depth research and the resolution of all G&A issues. Met and exceeded standards in terms of quality and quantity of member grievances.

LEGAL ASSISTANT THE LAW OFFICE OF STEVEN LOVETT 2016 - 2017

·Transcribed all dictation, faxing, scanning, daily mail, monthly billing and general office operations. Certified Notary Public. Proficient in court filing matters and obtaining liens for clients. Able to propound and respond to discovery issues, complaints and calendaring in Outlook. Familiar with California Civil Procedures and Local Rules. Experienced in probate, real estate and construction law.

ENROLLMENT AND BILLING SPECIALIST III ANTHEM INC. 2009 - 2016

·Processed all enrollments, plan changes, terminations and corrections for the National Accounts Division. Direct contact with the Human Resources Departments of our largest groups of customers. Maintained and reconciled all aspects of premium billing, self-billing, and individually billed accounts. Audited the premiums received, via Excel spreadsheets, to ensure the groups were paying within a reasonable guideline. Performed error output and resolution reports for electronic eligibility files received, processed Error, Discrepancy and Bypass Reports on a weekly basis. Participated with our Sales Team in both new and renewing group implementations. Understood all elements of the benefits and products offered: Medi-Cal, HMO, PPO, etc. Performed other duties as needed, such as mentoring, clerical work, auditing, etc.

·

References

Personal & Work References Available Upon Request.