Marlene Linke, Qebs Email & Phone Number

Orlando, Florida, United States

Support the execution of the client written service timeline and blueprint created by Client Executive.Collaborate and facilitate with Engagement and Health Strategies team on communication materials geared toward educating employees about their benefit or wellness program.Coordinate with Advocacy team on documenting and reporting on employer/employee issues in Benefit Point – eligibility, billing, claims, EOBs, trends, etc.Manage carrier issues on implementation, plan set up, file feeds, etc.Support Client Executive with client data accuracy and auditing of Benefit Point.Support Client Executive with data gathering and new client onboarding.Initial review of proposals, communications, and client plan documents to include SBC, SPD, certificates, Schedule A/Form 5500, contracts, carrier renewal/implementation paperwork.Initial/Draft completion of carrier renewal/implementation paperwork.Auditing of client files for completion to include all plan documents - SBC, SPD, Certificates, Schedule A/Form 5500, contracts.

Lake Mary, Fl

Retired 12/1/20Builds strong relationships with the client, proactively identifying the needs of the customer and satisfying the customer in a timely and cost effective manner.Develops case-level service strategy and manages service issues as it relates to overall plan administration; uses a creative, thoughtful approach to customize service delivery for client/consultant needs and attributes.Owns end-to-end service delivery and manages service recovery. Responsible for engaging internal matrix partners on escalated service issues including but not limited to billing, banking, eligibility, customer service, plan set-up, and claim payment.Partner with the Sales Executive during RFP process to fully understand the client intent with respect to benefit plans and administrative capabilities. Responsible for conveying do-ability, benefit design impacts to client/customer.Partner with Sales to oversee non-standard benefit submissions to PBAB to ensure all interrelated benefits coordinate to meet client expectations.Owns the client experience across the end to end on boarding / renewal process.Monitors overall health of the client (account metrics and performance guarantees) to minimize financial impacts, drive persistency, and improve client satisfaction.Provides Service Operations standard service reports to the account team and client. Analyzes data/trends and responsible for presenting results to the client.

Lake Mary, Fl

Build strong relationships with the client, proactively identifying the needs of the customer and satisfying the customer in a timely and cost effective manner. Develop case-level service strategy and manages service issues using creative, thoughtful approach to customize service delivery for client/consultant needs and attributes. End-to-end service delivery and manage service recovery including but not limited to billing, banking, eligibility, customer service, plan set-up, and claim payment. Build and sustain client relationships to enhance Cigna's reputation in the group health insurance industry.Benefit AdministrationPartner with the Sales Executive during RFP process to fully understand the client intent with respect to benefit plans and administrative capabilities. Responsible for conveying do-ability, benefit design impacts to client/customer. Partner with Benefit Implementation Lead to understand and execute on client’s plan interpretation and Cigna's service administration capabilities.Case InstallationManage the client experience across the end to end on boarding / renewal process.Lead implementation meetings with client and develop and present implementation calendar to client including matrix partner deliverables. Ensure technical experts are introduced to client as appropriate and partner with internal matrix partners to ensure timely and accurate implementations. Internal LiaisonFacilitate engagement between subject matter experts (benefit, service and customer/financial affinity coordinators) within Cigna to execute overall service strategy for client. Manages issue through and owns resolution. Partners with the Sales team in the development of client specific service strategies and in the pursuit of growth opportunities, and retail strategies.Data AnalysisMonitors overall health of the client (account metrics and performance guarantees) to minimize financial impacts, drive persistency, and improve client satisfaction.

Orlando, Fl

Manage the turnover process from Sales to Implementation in triage call by gathering all facts and documents utilized during the sales process.Establish a relationship with the employer group and broker contactsBuild implementation project timeline and manage meetings/deliverables including preparing agendas, documenting meeting notes and tracking issues. Gather all required supporting documentation from employer group or broker pertaining to on-boardingCoordinate the collection of information and communicate with the appropriate departments within PlanSource and with 3rd party vendorsCreate billing reportsWork with the Configuration Analyst as they update all required employer group documentation (CRG)Test the employer group's Benefits Administration site and in partnership with the Configuration Analyst, resolve identified testing issuesManage the flow/timeline of the implementation to the established deadlines and escalate when necessaryProvide reporting updates to internal teams or management.Lead employer group meetings to review functionality issues or participate in roll out discussionsProvide system training to the broker and employer group's key Administrative StaffManage the handoff process from Implementation to Service/Account Management to ensure employer group satisfaction and continuityRetain accountability for successful implementation projectsContribute to and/or maintain Standard Operating Process Documents (SOPS) and other processes performedComplete job-related training courses and/or seminars, as required for the job and/or assigned by Manager

Greater Philadelphia Area

Implement new and existing business for large case market generating over $10 Million in annual revenue. Participate in pre-sale presentations with potential customers and brokers. Supervise Implementation Specialist team. Received The President's Club Award for Excellence in Customer Service in 1999 for the successful implementation of Saint-Gobain Corporation which employs 30,000 employees and generates $50 million in annual revenue.

Greater Philadelphia Area

Provide customer service sales support to existing and new customers for large case market. Implement all new benefit programs for existing and new business. Create, order and collate enrollment benefits information for annual enrollment meetings. Conduct client entrollment meetings and ongoing service calls.

Greater Philadelphia Area

Provide customer service sales support to existing and new customers for small case market. Implement all new benefit programs for existing and new business. Create, order and collate enrollment benefits information for annual enrollment meetings. Conduct client enrollment meetings and ongoing service calls.

Hartford, Connecticut Area

Manage the technical development of business specifications for the Next Generation Medical Claim system. Supervise business analyst team. Research, develop and write business specificiations for the automatic adjudication requirements for PPO, HMO and Indemnity medical claims processing. Management, planning and cost benefits analysis

Hartford, Connecticut Area

Research and analzyze the automation potential and feasibility of retrofitting system enhancements to existing medical claim payment system. Participate in the analysis of multiple vendor medical system designs for applicability to CIGNA*s business. Provide written documentation of all business specifications for the automatic adjudication functionality of all lines of medical benefit plans including Indemnity, PPO and HMO business.

Hartford, Connecticut Area

Research, define and develop business specifications for the automatic adjudication enhancements for the Dental claim payment system. Design, publish and test training materials for data entry and data correction functions. Analyze data entry requirements for provider Electronic Claim Submission and Optical Character Recognition functionality.

Wilmington, De

Interview, hire and train all new medical benefits analysts. Conduct monthly in-house audit program with quarterly trends analysis and process improvements. Achieved highest office quality rating in the nation for the

Wilmington, De

Process medical claims for large case clients utilizing various reference materials in the analysis and benefits interpretation. Assisted Medical Trainer/Auditor with monthly in-house audit program.

Wilmington, De

Process dental claims for large case clients manually and via data entry system. Handled customer service calls, conducted monthly dental claim in-house audits.

Newark, De

Manage retail clothing store. Interview, hire, train and schedule sales staff. Perform annual inventory and financial goals assessments.