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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Street Address
West Milford, NJ Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLEProfile Professional with a proven track record of excellent teamwork and supervisory skills in reaching enterprise objectives.Strengths Change Leadership Management Operational and Support LeadershipCorporate ComplianceData Integrity/Data ManagementCustomer RelationshipProcess Improvement EvaluationExcellent written/verbal communication skillsEducation Passaic County Community CollegeTechnical Skills Microsoft Word, Excel, PowerPoint, Access, Lotus Notes, TPX Session (NMS), HRS (Horizon Renewal System), PQS (Premium Quotation System), PIBA, SARS, OutlookCareer History Horizon Blue Cross Blue Shield of NJ Newark, NJ2004 - PresentRating Analyst II Ensures the accuracy of the monthly renewal process, to include creating renewal files, loading rates in the New Membership System and making enhancements to the renewal system, as needed. Responsible for the successful generation of rate tables and the timely distribution of rating disks to internal sales team and broker community. Generates manual renewal requests and quotes as needed. Serves as internal customer contact to explain rate increases and provide rate justifications. Serves as external contact to respond to Department of Banking and Insurance/Small Employer Health Board inquiries. Responsible for the generation of designated reports for the Department of Banking and Insurance. Responsible for quarterly testing of various processes to check for errors and provide solutions. Assists with all functions of the Compliance Specialist as needed. Performs other duties as assigned by management.Compliance Analyst Performs audit of small employer sales paperwork and certification forms upon renewal to ensure compliance with internal underwriting guidelines and state/federal law. Notifies brokers and sales representatives of underwriting rules and regulations as well as identifies incomplete applications and informs them of approvals and or denials of eligibility. Performs necessary research in order to respond to customer inquiries. 2003 - 2004Contract Analyst Develops and issues Individual and Small Group contracts and booklets which legally define Horizons benefit obligations to individual subscribers, the group or other Blue Cross/Blue Shield plans. Modifies previously developed text to meet the unique needs of a particular group. Provides interpretation of contractual benefits and administrative provision for Individual and Small Group. Researches, analyzes benefit change requests as needed to update benefit file (PIBA System). Prepares riders for benefit changes for Individual and Small Group2001 - 2003Administrative Assistant Provides the manager and other staff members with complete and timely background information on all telephone calls and correspondence. Provides routine typing and copying support to staff to facilitate timely communication of information. Maintains files and records through the utilization of various PC software. Maintains attendance, payroll and benefit records for regular submission to Human Resources. Creates, develop and maintains databases related to departmental activities and special projects.1998 - 2001ReferencesWill Be Furnished Upon Request |
