Jennifer B. Email & Phone Number

Greater Seattle Area

Sr. Contract Specialist with vast experience and responsibility for all aspects of development, issuance and compliance of member and group contracts for complex and marquee employer and provider groups including facilities and associations. Provide all levels of support for implementation of new national accounts or provider networks; including participation in cross-departmental implementation work groups. Research, analyze and provide interpretation on complex and abstract issues relating to assigned groups or providers. Collaborate with other proprietary departments to ensure that benefit and administrative provisions for assigned contracts are consistent with contractual intent and regulatory requirements. Complete required state regulatory filings for assigned groups. Serve as the primary resource in resolution of regulator issues and inquiries related to those filings. Work directly with outside clients including Producers and Group Benefit Administrators as needed. Develop customized language; identify and resolve contract and compliance issues relating to implementation of customized contracts. Develop and maintain contract language for specialty products (such as consumer driven health plans, provider settlement agreements, Quality Incentive Plans, etc.) and file products with the appropriate regulatory agency as necessary. Lead or participate in cross-departmental work groups as required in carrying out new network, product, benefit, and policy implementation functions.Provide support to customer service benefit quoting tools, language and other customer facing processes. Identify and assist with implementation of inter-departmental process improvements. Admirable ability to work remotely and maintain professionalism both visually and verbally. - You can count on me!

Greater Seattle Area

Primary role responsibility is to produce and file all small group health care (medical, dental, vision) plan forms with the Washington Office of the Insurance Commissioner (OIC). Analyze all details of the form filing for compliance with implementing state regulations under internal legal guidance. Analyze impact of proposed or implemented legislation/regulations and internal initiatives on our products and provide detailed analysis of potential compliance risks and impacts. Review, draft, and finalize contract language and assure contracts comply with all applicable federal and state health insurance laws, regulations and company internal directives. Provided direction to the company's book of business on the application of such laws and regulations, and complete regulatory form filings. Submit electronic product form filings using approved electronic filing formats. Lastly, exemplified professional relationships, team building and integrity with regulatory or governing bodies.

Greater Seattle Area

Appeals and grievance specialist that coordinated all parts of a Level II Appeal for members. Research, resolve and respond to Level II Member Appeals for multiple lines of business. Proficient in key appeal-related analytical functions, while addressing inquiries of current and potential member appeals; coordinating and communicating cross-department’s Management and other resources regarding member’s benefits, claims and eligibility issues. Consult with all departments and customers. Developed and administrated new Level II Appeal outlines, reports and process improvements. Lead cell coordinator proficient in reviewing daily reporting in a proprietary Appeals Tracking Database (ATD) of the case loads, work in process and identifying order to triage cases at risk. Provided monthly and annual reporting of Panel Medical Director and Assistant Medical Director participation. Collaborated with executive level personnel and other management leaders with appeal findings, documentation and information pertaining to cases and decisions.

Greater Seattle Area

Perform a variety of key high-level customer service and provider-relation functions, addressing inquiries of current and potential member, communicating with cross-department and vendor partners regarding member’s benefits, claims and eligibility issues. Collaborate with Microsoft Benefits Department and On-Site Representatives to oversee all e-mail correspondence of the benefits website. • Developed and administrated team morale building events, such as Team Rallies to cover and educate all attending employees on policies, recognition and upcoming events, as the President of “Committee in Action”. • Coordinated and hosted successful employee seminars, creating invitations, slide shows, promotional materials, booking venues, and selecting guest speakers.• Strong understanding of quality, Lean and production goals• Provide feedback and procedural alterations to improve processes and improve productivity.• Developed MS Excel spreadsheets to improve, inform and report quality to the Manager and National AccountsRecognized and bestowed a Vendor Award for Excellence, two years in a row (2005 and 2006), in addition to being a proud recipient of Premera’s “Spirit of Excellence” award.

Greater Seattle Area

Part of a dedicated team to deliver a responsive, cost effective staffing solutions. Took on the management and ownership of all or part of job profiling through the onboarding of the new hires, including providing staff, technology, repeatable talent management practices and reporting. Performed initial interviews for Recruiters, matched up skill sets by areas, industries and proficiency. Consulted and counseled new clients to develop a professional resume, letters and compensation packages. Whether our client's objectives were to accelerate time-to-market, develop new product innovations or manage costs by outsourcing non-core functions, the corporation provided clients an edge to compete.

Greater Seattle Area

Responsible to interview, on-board and train new representatives for a call center environment for a health care plan. Develop all training materials, procedures and facilitate all training and auditing report-outs. Took initiative to have consistent work performance and entrepreneurial enthusiasm. Became a natural project manager developing and implementing projects to report progress. Ability to work independently and understand the dynamic environment, quality-focus and customer service driven nature of a plan.