I review and scrutinize RFPs received from producersI scrub census and analyze experience reportsI perform manual rating and prep the case for the underwriting consultant

Audit reimbursement requests against the terms of the applicable Stop Loss Policy, including incurred and paiddate range, specific deductible, split funded deductible, domestic reimbursement percentage, etc.§ Review claimant’s eligibility under the terms of the Group’s Plan Document, Employee Handbook, Short andLong-Term Disability policies§ Analyze paid claims reports submitted by TPAs separating paid charges into service types to facilitate forecastingby TM HCC actuaries and underwriters§ Set reserves for each claimant via predictive analysis of prior claims experience, pre-certifications, LCM notes§ Maintain working correspondence with TPAs and brokers regarding cases under review§ Utilize David Young Consulting’s tpaAdvantage software in the claims adjudication processAccomplishments: Successfully completed the pilot online training program achieving consecutive pay authorityand daily assignment increases and maintaining 100% financial and 99% procedural accuracy.

Place stop loss coverage for prospective and existing clients.Prepare monthly stop loss reporting. Problem solve. Train team-members.

Place, administer and coordinate stop loss for self-funded employers and HMO Re experience from beginning to end:- Negotiate policy terms with underwriters and market stop-loss proposals on the front end;- Monitor claims experience and file for specific and aggregate reimbursement following through all the way till the group gets its money on the back end;- Maintain periodic and as-hoc reporting as required by all the parties involved; - Monitor and report excess loss for self-funded groups;Ensure timely and accurate specific and aggregate stop-loss and HMO Re reimbursement;- Assist in procuring stop-loss coverage for self-funded groups;

Process prior authorization requests

In 2016 CHI introduced a new Medicare Advantage Plan to Central Arkansas.We achieved record enrollment during Annual Enrollment Period exceeding all goals.Responsibilities included educating Medicare beneficiaries about QualChoice Advantage Medicare Advantage plan and convincing them to join through:-Presentations-In-home visits-In-bound and out-bound phone calls-Community events

Raising a preschooler and a toddler;

Account opening; financial review; financial recommendations; referrals to other lines of business such as mortgage loan officers, business and merchant services, Merrill Edge financial advisors, commercial credit, small business credit; customer service; notary public; banking center operation; cash management;• Performed consumer (retail) customer financial needs assessment and analysis• Performed small business financial needs assessment and analysis• Identified small business customers credit and lending needs and fulfilled them either by initiating the process of opening a business credit card or referring to the commercial and business lending department• Assisted customers in problem resolution while providing superior customer service and identifying opportunities to deepen the customer relationship• Consistently reached and exceeded sales goals in partner referrals and account opening• Stayed current with constantly changing applicable government regulation and internal bank policies through continuing education and individual efforts• Processed customers’ transactions in a fast and accurate manner and provided superior customer service• Helped the bank maximize share of wallet by referring new products to customers and warm-transferring customers to other lines of business• # 1 Sales and Service Specialist in the Market (out of 16), # 10 in the Area (out of 79)• 1 Gold Award, 1 Silver Award, 5 Bronze Awards for professional excellence

• Analyzed financial statements and data from the real estate properties held by the company• Supervised receipt and appropriate allocation of funds from real estate properties held by the company• Realized savings for the parent company through proper control and oversight and performing ad hoc audits• Assisted the owner in gathering required documentation for commercial and bridge loans approval• Turned the properties around from loss to profit in less than a year• Reconstructed rent-roll history for the two years preceding my arrival

• Conducted direct marketing campaigns via e-mail, direct mail, and telephone to prospect, approach and solicit top-level executives, professionals and business owners in Dallas/Fort Worth in order to provide them with sartorial advice, services, and merchandise• Added 120 new clients to the company client base• Provided superior customer service to ensure customer retention and loyalty• Persuaded over 100 former dissatisfied customers to return to the company• Executed extensive research and analysis within the sales territory to identify viable prospects

• Personally recruited and trained an eight member sales team to achieve a three-month team sales revenue of over $100,000 in June-August 2005• Lead, managed and motivated a 30+ member sales organization in the summer of 2005• Personally recruited, trained, managed and motivated teams of multiple sales representatives in 2002-2004• Conducted door-to-door direct sales campaigns in the states of Michigan, New York, Tennessee and Iowa• Performed analysis of team sales data and sales trends

Translator/Interpreter with BJ Services (now part of Baker Hughes) joint ventures in Siberia