Senior Benefits Advocate with 18 Years Experience

Professional Summary

Professional Experience

Skills

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Certifications

Education

Martha Bernd

Temecula, CA 92592 949-***-****

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

Senior Advocate – Solutions with 18 years of experience in understanding of how employee benefits are related to the positive reputation of the company and retention of quality employees. Consistently advocating on behalf of employees and known for high productivity and efficient task completion. Possess specialized skills in legal research, case management, and client advocacy. Excel in negotiation, critical thinking, and communication, ensuring successful outcomes in challenging scenarios. Senior Advocate-Solutions, 02/2020 Current

Piper Jordan Health & Benefits Partners, LLC

San Diego, CA

· Build client sites, including benefit plan rules, details, prices, text and documents

· Test client sites to ensure proper functionality and quality

· Conduct regression testing to discover software

enhancements or needs Import data into system as

needed and assist with ad hoc client projects

· Prepare employee and employer communication

documents

· Triage client tickets and questions via email and voicemail and provide next response time

· Create and maintain Open Items Logs for clients

· Audit system data from various sources and produce reports about summary and details

· Answering inbound calls from specific clients and their employees

· Resolve any data discrepancies with external vendors

· Perform billing tasks such as invoice generation, posting payment, and reconcile receivables

· Audit carrier invoices between various data sources and provide summary of the findings

· Ensure compliance with government agencies and

corporate policies and procedures

· Attend training sessions, courses, etc. to maintain up- to-date skills

· Always conduct the highest level of confidentiality Built and configured employer benefits platforms in bSwift, including medical, dental, vision, life, disability, FSA, HSA, and voluntary benefits.

· Set up eligibility rules, plan years, waiting periods, evidence of insurability (EOI), and enrollment

workflows for new hires, open enrollment, and life events.

· Configured payroll deduction schedules, payroll

exports, and deduction change files to support accurate payroll processing.

· Built and maintained inbound and outbound data feeds, including demographic imports and carrier export files.

· Tested configurations in testing environments and validated results prior to production deployment.

· Troubleshot file errors, eligibility issues, and plan configuration discrepancies in collaboration with

carriers, vendors, and internal teams.

· Supported client onboarding, renewals, and mid-year benefit changes, ensuring compliance with client

requirements and system rules.

· Created and maintained documentation, reports, and client communications related to system setup and

changes.

· Worked cross-functionally with HR, payroll, carriers, and third-party administrators to ensure accurate benefits administration.

. Employee benefits processing

. Compliance laws (HIPAA, COBRA, ACA)

. Leave of Absence Administration

. Oral communication

. Bilingual

• www.linkedin.com/in/martha-bernd

• California Life & Health Agent License

• Medical Assistant

· Support the Client Services team or other areas of the business, as needed Advocacy

· Be on the frontlines of resolving a variety of member inquiries to help people understand their benefit plans

· Research member questions and plan issues

· Effectively resolves problems within the Advocacy department, as well as escalated customer

conflicts/complaints, in a fair and equitable manner.

· Provide technical support and assist customers in using web-based, employee self-service tools, and be able to troubleshoot basic technical support issues for CSRs

· Maintain complete and accurate call and case notes

· Read and understand the client's plan documents, amendments and online knowledge base tools.

· Participate in development of knowledge base tools and client implementation

· Educate members about enrollment options, paying close attention to details, while maintaining composure during difficult conversations

· Process benefits enrollments and qualified life events updates for members

· Support the Client Services team or other areas of the business, as needed

· Foster and seek relationships with teammates across all levels of Piper Jordan and Brown & Brown

· Ensure compliance with government agencies and

corporate policies and procedures

· Attend training sessions, courses, etc. to maintain up- to-date skills

· Always conduct the highest level of confidentiality

· Complete special projects as needed

· Other duties as needed

HR Assistant, 01/2018 12/2019

PADI Worldwide Rancho Santa Margarita, CA

Processing all employee leave of absences,

including follow up with employees and

managers to ensure all documents have been

completed

•

Review all leave of absence request forms and

support documents submitted by employees

•

Coordinating with payroll for processing sick and

vacation, holiday pay, and any off cycle

paychecks when needed

•

Assisting employees with EDD filing for

disability and/or Family Paid Leave

•

Initiating interactive processes with employee on

leave of absence and coordinating with HR

Manager to facilitate accordingly

•

Coordinating employees return to work and

processes all documentation

•

Kaplan Financial Irvine, CA

Bryman College Anaheim, CA

Demonstrating oral and written communication

skills and communicating effectively with

various internal and external contacts.

•

Performing other duties and/or special projects

when needed

•

Assisting the HR Manager, HR Specialist, and

Payroll Administrator for any projects

•

Assisting the HR Manager with generating and

tracking employee commission agreements

•

Assisting with the distribution of performance

reviews

•

Assisting with the preparation and distribution of various HR communications

•

Overseeing administration and tracking of

Harassment Training for managers and staff

•

Auditing I-9 files to ensure compliance and

current information is on file

•

• Auditing of all employees files for completeness Assisting the HR Manager with employee

onboarding and reference checking

•

Assisting the HR Manager with phone screening

and scheduling of candidates as needed

•

• Preparing New Hire Packets

Assisting the HR Specialist with benefit

administration

•

Assisting employees with questions regarding

health insurance benefits

•

Assisting the HR Specialist with health fairs and

open enrollment

•

Creating and maintaining the department

procedures manual

•

Assisting with the employee fun committee with

special events

•

• Managing Lunch N Learn with vendors

Participating in company meetings, webinars,

and conference calls

•

Benefits Supervisor, 01/2016 01/2018

CKE Restaurants Holdings, Inc. Anaheim, CA

Managing the Wellness Program and

coordination all wellness events

•

Assisting with annual enrollment meetings and

Health Fairs

•

Displaying outstanding leadership skills by

providing coaching, guidance, and development

advice to a staff of 3 employees

•

Assisting employees with questions regarding

health insurance benefits and resolving claims

issues

•

Partnering with other business function

departments, various insurance carriers,

•

administrators, service providers, and consulting

to optimize benefit program results

Creating and maintaining the department

procedures manual

•

Managing special reports for the department and

assisting with all benefits related audits

•

Attending seminars and completing other training

to remain current on industry trends

•

Participating in company meeting, webinars, and

conference calls

•

Responsible for the benefit administration for

7,000 lives

•

Assisting in system testing for system

enhancements or Open Enrollment

•

Identifying part-time employees who are

measuring full-time and offer them benefits

under ACA guidelines

•

Processing 1095c validation and working with

ACA vendor to ensure that are accurate

•

Performing other duties and/or special projects

given by the VP of Benefits

•

Senior Benefits Administrator, 01/2007 01/2016

Precept / ProView (owed by BB&T) Irvine, CA

Manage client interactions, inquiries, and

meetings related to the setup and ongoing

servicing of the client benefits plans

•

Coordinate and leverage the work of support

personnel

•

Ensure the deliverables of the team meet internal

and client delivery standards for timeliness and

quality

•

Implement and manage department standards,

processes, and procedures within the client team

•

Train team members on the processes for new

clients and changes to existing clients

•

Report status and metrics for internal and client

use

•

Expertly and swiftly resolve employee health and

welfare benefit plan issues and assist with

overflow calls from the Call Center

•

Report payroll changes to our clients timely,

providing updated confirms and/or reports

•

Prepare and send out new hire packets and

mailings.

•

• Process all over age dependents

Assist employees with claim questions, EOB

explanation, and claims re-submission to carriers

•

Ensure that all internal/external inquiries are

responded to and resolved within established

guidelines

•

Process, audit, and maintain benefits

administration systems daily

•

• Scan and file all employee documents

Respond to all client service tickets on daily

basis

•

Audit activities including new hires, qualified life event changes, terminations notifications, and

changes to carriers on a daily basis

•

Assist with Data testing for eligibility

management

•

Process and manage Leave of Absence and

Retiree enrollment changes

•

Follow all document retention and filing policies

and procedures to ensure details of all employee

discussions and transactions are properly

recorded and stored

•

Effectively partner with Carrier Representatives

to swiftly resolve outstanding employee issues

•

Handle and resolve escalated carrier plan

availability issues

•

Review carrier invoicing prior to client delivery

by our Billing Department

•

Complete discrepancy resolution for assigned

issues

•

Review and correct each carrier discrepancy

report after an electronic feed has been passed

•

• Attend weekly meetings with broker and clients.

Attend weekly Client Centric Meetings with the

broker.

•

Responsible for the benefit administration for

employer groups up to 12,000 lives

•

Attend annual Enrollment meetings with

employees and represent employer in Health

Fairs

•

Identifying part-time employee who are

measuring full-time and offer them benefits

under ACA guidelines

•

Contact this candidate