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Customer Service Medical

Location:
Longwood, FL
Salary:
40,000
Posted:
August 22, 2012

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Resume:

Maxine L. Stanley

**** ****** *****

Longwood, FL 32779

Home: 407-***-****/Cell: 407-***-****

Email: iobj58@r.postjobfree.com

Areas of Expertise: Advanced Microsoft Excel, Word, PowerPoint and Outlook; financial analysis and accounting experience; insurance and medical claims background; strong organizational, analytical, interpersonal and writing skills.

Education: B.S. degree in Medical Records Administration, University of Illinois, with honors (1977); 12 accounting and business courses taken post-graduation.

Experience:

04/06 – 10/11 Great American Insurance Company

Compliance Product Analyst (ELD Division, Schaumburg, IL.)

• Filed insurance forms and rates for Directors and Officers Liability, Employment Practices Liability and other insurance products in all 50 states; well-versed in filing requirements for individual states and SERFF filing software.

• Set up and maintenance of agent licensing information in computer database; excellent rapport with agents, brokers and underwriters.

• Created and designed policy forms and endorsements using advanced Word skills.

• Prepared financial exhibits and spreadsheets to submit with rate filings.

• Used Excel spreadsheets as organizational tool for tracking filings and designed a master spreadsheet to organize and consolidate rate plans by product and state.

Risk Management Coordinator (LPL Division, Maitland, FL.)

• Provided risk management materials and publications to attorneys.

• Design, layout and mass mailing of quarterly Risk Management newsletter.

• Organized Continuing Legal Education programs for law firms including the 2007 biennial CLE convention, in Las Vegas, attended by over 200 attorneys.

• Miscellaneous administrative duties including communication with vendors, ordering supplies, processing invoices, etc.

02/02 – 07/05 Hannover Life Reassurance, Orlando, FL

Financial Analyst

• Prepared monthly reinsurance reports, input and reconciled billing components in accounting system, invoiced clients and resolved discrepancies.

• Prepared quarterly profit and loss work papers and other financial exhibits.

• Project coordinator and recording secretary for several company-wide committees: prepared meeting minutes, agendas and monitored work/task completion by members.

• Evaluated work flow, wrote and developed procedures and designed forms to simplify processes.

01/90 – 05/01 Universal American Insurance Company, Lake Mary, FL

System Support\Product Implementation Specialist

• Set up and maintenance of insurance parameters on computer mainframe.

• Product implementation and system conversions, testing and trouble-shooting system problems, documenting and implementing corrective action.

• Saved the company over $500,000 by detecting a premium billing error and implementing corrective action.

Financial Analyst

• Prepared financial work papers and reports in Excel.

• Analyzed and audited financial data and system-generated reports.

• Assisted Chief Actuary with reserve calculations and testing projection software.

Medical Claims Analyst

• Processed medical claims according to contract provisions.

• Oral and written communication with health care providers, agents and members to explain claim decisions.

Central States Health and Pension Fund, Rosemont, IL

1/87 – 5/88 Supervisor, Financial department

• Supervised check disbursements unit (6 FTE).

• Performed month-end bank reconciliation and financial forecasts.

• Wrote procedures and implemented work simplification processes.

1/84 – 1/87 Staff Development and Trainer

• Orientation and instruction of new claim adjusters.

• Designed training programs and procedure manuals.

1/80 – 1/84 Medical Claims Adjuster and Quality Analyst

• Processed medical claims; review and audit other analysts’ work.

Professional Designations:

FLMI, Fellow Life Management Institute, with distinction – earned 1994

HIA, Health Insurance Associate – earned 2003

ACS, Associate of Customer Service – earned 2004

RPLU, Registered Professional Liability Underwriter – earned 2011

Other Attributes:

• Extensive writing experience including training and procedure manuals, job descriptions, meeting minutes, work flow analysis, design of forms and marketing materials, layout and design of newsletters.

• Creative and innovative.

• Enthusiastic and energetic.

• Detail oriented.



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