Beth Clark, Ffsi, Flmi, Airc, Acs Email & Phone Number

Tampa/St. Petersburg, Florida Area

"Here to Help" Benefit Specialist: Enrollment Facilitation; New Hire Support Services; Plan Coverage Inquiries; Life Event Administration and Eligibility Inquiries.

Clearwater / St. Petersburg, Florida Area

Insurance professional with a working knowledge of administration procedures, complaint resolution procedures, product development and quality assurance. Responsibilities included: Third party administration annual license renewals, reporting to state departments, monitoring regulatory developments, renewal of corporate insurance and bonding requirements; New policy development; for Life and Health policy forms, rates and marketing materials for Medicare, Medicare Advantage, Medicare Supplement, Long Term Care, Life & Health and Critical Illness lines of business.

Clearwater, Fl

Coordination of Special Needs Trust - Protecting people with disabilities. Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet the individual’s needs and to promote quality, cost-effective outcomes. I worked with a team-based staff to ensure public benefit programs such as SSI, SSDI, Medicare, and Medicaid benefits remain protected. The focus is on the clients short and long term care needs. A plan of care is designed to maximize resources with the creation of a budget. An annual financial analysis is performed to ensure that trust accounts are effectively managed. Clients are educated on the different expenditures, in which the trust is allowed to pay. Case mangers provide assistance in the payment and reimbursement process, of client requests, from the trust account, by using available resources and working with local vendors on planning issues. The Trust meets the individual's special needs with funds for recreation, transportation, medical costs, and housing subsidies. In order to preserve needed assistance, the focus is on research, client education and application of the rules of Public/Government Benefits like SSI, SSDI, Medicare, and Medicaid. The underlying premise of case management is based in the fact that when an individual reaches the optimum level of wellness and functional capability, everyone benefits: the individuals being served, their support systems, the health care delivery systems and the various reimbursement sources.My Specialties Include: Building and Maintaining Relationships, Customer and Personal Service, Problem Solving and Decision Making, Resource Allocation and Coordination, Effective Listening and Empathy.

St. Petersburg, Fl

Helping members, providers, and vendors with claims, enrollment, and pharmacy inquires. Assisting with communication issues to providers and members. Providing one call resolution through expertise in state and federal regulations. Primary contact for escalated calls and/or escalated issues, in which special care is required to enhance Universal Health Care's relationships with members and providers. Investigating problem areas and presenting solutions that drive and support Universal Health Care's initiatives, policies, procedures, and values. Responsible for compliance in relation to federal and state regulations when dealing with member or provider data.

Largo, Fl

• Worked with actuarial, product development, and marketing to drafting language to meet regulatory requirements and assisted in form and advertising design to bring the product to market• Managed policy issue, maintenance and regulatory form changes • Developed relationships with state regulators and prepared filings of forms, rates, and advertising for approval. Additional filings included but were not limited to annual rate filings, endorsement and rider filings• Monitored and filed annual regulatory reports, rate surveys, and data surveys• Performed high-level regulatory research for multiple clients and provided advice to the company’s new business, policy owner services and claim departments• Prepared and distributed a weekly compliance report of proposed and approved regulatory activity and determined the applicability and action required for each area• Investigated and responded to both direct complaints and DOI complaints

Largo, Fl

Incoming Call Center April 2001 – November 2003• Provided prompt, courteous customer service• Utilized policy forms, insurance law and internal procedures to answer inquiries and process a multitude of request from policyholders and their legal representatives• Maintained policy master files• Processed premium payments and various policy changes due to cancellations, lapses, reinstatements, ownership changes, beneficiary changes, loans and assignments• PROMOTED TO PRODUCT DESIGN ANALYST / REGULATORY COMPLIANCE