Darla Lowe Email & Phone Number

Des Moines, Iowa Area

• Develop and produce high quality benefit documents.
• Create member SPD’s/Coverage manuals for IA/SD large & small groups -fully insured and self funded.
• Research group information on the online benefit system
• Compare new documents against previous years and verify languagechanges against current customizing catalog
• Ensure compliance of benefit documents with the Insurance Regulationsand Wellmark guidelines by staying informed of legal requirements thatimpact customer
• Research customer and provider benefit inquiries and respond to Internalsales, Brokers/Agents and Legal on a daily basis by phone or email.

Des Moines, Iowa Area

• Processed claims, documents and inquiries for customers and stakeholdersto eliminate defects and additional re-work
• Performed quality processing of claims - 100% accuracy
• Ensured timely processing of claims and inquiries to meet customerexpectations
• Researched membership and provider information from variousapplications
• Made phone calls to Providers and other insurance carriers to verify info

Des Moines, Iowa Area

• Adjudicated claims for insured according to health plan guidelines(hospital, skilled nursing facility, home health, hospice, physician, durablemedical equipment, ambulance and surgery)
• Corresponded with insured’s and providers with prompt information,
• Collaborated with other insurance explanation of benefits to obtaininformation
• Review claim requests to determine eligibility and escalate issues as theyoccur
• Ensured utilization of processes and procedures; Identified processimprovements

Waukee, Iowa

• Managed daily operations, budget, supplies, deliveries
• Managed customer interactions in order to provide services to meet theirneeds
• Packaged, shipped, copied, sorted, faxed, bounded documents, andlaminated services for customers
• Provided notary services
• Maintained knowledge of UPS, FedEx, DHL and USPS shipping regulations
• Ordered supplies and managed inventory

Des Moines, Iowa Area

• Prepared and analyzed data used to produce small group and renewalquotes
• Performed post-sale Underwriting functions to verify group eligibility andcontribution requirements (ie: Jobs Service report, ownershipdocumentation, Agent of Record)
• Request missing information from Internal sales, Brokers/Agents by phoneor email
• Processed benefit changes for groups selecting new benefit plans
• Gained extensive knowledge of small group reform law and small businessenrollment guidelines
• Trained and mentored new team members on processes and guidelines