Denise Pace Email & Phone Number

Bethesda, Md, Us

• Created SOP for all Reinsurance Stop Loss Specific functions for newly formed Stop Loss department. (Javelina, SecureLinQ, and Ringmaster)• Cleared backlogged eligibility for 35 employer groups utilizing combined TPA business partner platforms (P2P, Ringmaster, Javelina, SecureLinQ)• Fostered positive relationships between management team, interdepartmental team, clients, and brokers.• Communicated with Account Managers, Customer Service Reps, and Account Services Reps to request and generate monthly Stop Loss Trigger DX, 50% reports, and Aggregate Reports to carriers and MGUs (P2P, CedarGate)• Guided, advised and supported Executive Management in complex account resolutions. (Javelina and Phia)• Trained existing and new staff members in operational procedures and best practices for newly created business processes. (Javelina, Ringmaster, P2P)• Designed, created, and implemented practices to clear $2.6M in pended eligible Stop Loss reimbursements. (Javelina, Ringmaster, CedarGate)

Billings, Mt, Us

• Generated specific summaries and paid claims details reports in preparation for distribution to necessary parties and for filing specific reimbursement requests. (Javelina and Collybus)• Managed pipeline for 85 self-funded employer groups’ stop loss submission and reimbursement requests (Javelina, Collybus, iSuites)• Determined and pulled claims for advanced (simultaneous) funding. (Javelina)• Requested and maintained status updates on progress of advanced (simultaneous) funding requests and reimbursements. (Javelina)• Submitted, received, and logged reimbursements in excess of $2M. (Javelina and Tracker)• Requested, reviewed and forwarded Active at Work eligibility forms in addition to necessary FMLA, STD, and COBRA paperwork (Javelina, Collybus, MiBenefits)• Maintained accurate records of RX information for stop loss submissions.

Little Rock, Ar, Us

• Reviewed necessary documents for stop loss submissions prior to handing off to senior stop loss specialist and team lead for high dollar submissions. • Assisted with compiling all documentation needed to perform monthly audits for stop loss reimbursements that have been received.• Handled confidential eligibility documents in accordance with contractual and legal regulations.• Proofread all submission documents for accuracy prior to submission for reimbursement for senior stop loss specialists (DYS)• Complied paid claims details, specific reimbursement forms, LCM notes/invoices, and eligibility verification for stop loss filings to load into DYS

Columbus, Ohio, Us

• Reviewed and submitted reports for fraudulent activity.• Gathered evidence including written and recorded statements, financial and audio materials.• Detected and prevented over $4M in fraud and Identity theft. • Direct contact with customers and financial institutions to investigate and resolve fraud and identity theft claims

• Examined documents to verify adherence to regulatory requirements.• Conferred with colleagues regarding lending regulations, policies, and procedures in relation to complex loan documents to branch personnel.• Explained fundamentals of loan origination, documentation, and compliance regulations.• Conducted routine maintenance from loan origination throughout loan closing.• Reached independent decisions by utilizing computerized data entry to track and gathering information.• Trained, coached, and mentored new hires.

Us

Initiated and processed all leave tpes including FLMA, STD, and LTD for eligible Walmart employees.Verified leave and employment eligibility. Collaborated with Walmart's internal HR department for complex leave cases to ensure time available and taken remained compliant with state and federal guidelines.Assisted with educating Walmart employees with medical, dental, vision, 401k, and other employee benefits as needed

• Collaborated with sales, processing, underwriting, and closing teams to identify and develop solutions to improve document/scanning imaging system process and procedures.• Resolved issues in timely manner to ensure effective resolution and customer satisfaction; communicated new changes to team as directed.• Prepared financial/ regulatory reports required by laws, regulations, and senior management.• Established relationships with customers to aid with problems customers encountered for resolution.• Analyzed information and evaluate results to choose best solution and solve problems.• Communicated to supervisors, co-workers, and subordinates by telephone, in written form or e-mail.• Initiated and approved response letters for escalated situations involving mortgage customers, bank personnel and upper management inquiries surrounding loan origination and loan closing discrepancies.• Monitored and evaluated customer comments to achieve desired customer satisfaction

Bachelor Of Science - Bs, Human Resources Management And Services

Bachelor Of Applied Science - Basc, Human Resources Management/Personnel Administration, General