Barbara Duff Email & Phone Number

Madison, Wisconsin, United States

Janesville, Wisconsin

Madison, Wisconsin

• Developed a 50-state chart for health insurance claims processing standards applicable to specialty health insurance products.
• Drafted a 50-state chart outlining internal and external review requirements for appeals for specialty health insurance products.
• Revised base plan documents for an existing individual short-term medical insurance policy to resolve inconsistencies in terminology and tone, and to ensure clear and consistent explanation of benefits and coverage.
• Drafted plan documents for a new, limited medical benefits fixed indemnity group insurance policy.
• Modified base policies and related plan documents to comply with state requirements prior to filing.

Madison, Wisconsin

• Primary Responsibilities:
• Develop insurance plan documents and amendments to meet business needs and satisfy regulatory requirements.
• File policies and plan documents with the Wisconsin Office of the Commissioner of Insurance via the SERFF filing system.
• Maintain templates for creating a compliant Summary of Benefits and Coverage (SBC).
• Instruct operational areas on proper development of all contract documents related to group benefit plans.
• Provide regulatory guidance to the product development and management staff in developing new products and benefit programs.

Madison, Wisconsin

• Primary Responsibilities:
• Managed large caseload of initial and ongoing disability claims.
• Reviewed disability claims along with supporting medical, occupational, and collateral evidence, to evaluate eligibility for disability benefits as defined by applicable policy provisions.
• Created detailed claim files summarizing relevant medical and non-medical evidence, detailing disability allegations and rationale for the final disability determination.
• Explained final disability determination to claimants, verbally and in writing, citing applicable policy provisions and relevant medical and non-medical evidence supporting the decision.

Madison, Wisconsin

• Primary Responsibilities:
• Supervised a unit of disability examiners.
• Trained examiners in the application of Social Security disability rules, regulations, guidelines and procedures.
• Promoted independent research of resources to make accurate disability determinations.
• Monitored weekly staff performance and recommended effective or alternative caseload management and claims adjudication practices to promote outcomes that met quality and quantity goals.
• Mentored staff on performance improvement plans.

Madison, Wisconsin

• Primary Responsibilities:
• Managed a staff of twenty focusing on training and development, quality control, conflict resolution, decision-making, risk assessment, problem solving, customer service, workflow and process review. Monitored.
• Interviewed, hired, trained, and monitored job performance of departmental staff.
• Developed and monitored budgets for the Underwriting and Eligibility departments.
• Created and monitored inventory tracking and audit mechanisms to evaluate staffing needs, existing processes and procedures, and attainment of departmental and corporate goals, via development of an Access database.
• Initiated and led system improvement initiatives.

Sauk City, Wisconsin

Sauk City, Wisconsin

Madison, Wisconsin

Chicago, Illinois

Bachelor’S Degree, English/Language Arts Teacher Education, 3.7 Gpa

Dean's List. Awarded the Cardinal Newman Award for outstanding senior thesis in the English department. Graduated Magna Cum Laude.

Technical Communication Certification

I have successfully completed six courses required to obtain the Technical Communication Certification. Courses included: Technical.