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A business writer of advanced skills with regard to defining and defending posit

ions, providing instruction on methodically achieving objectives and presenting

complex concepts in an understandable, structured manner. "Toolkit" includes an
extensive technical and non-technical vocabulary combined with creativity and a
well-practiced command of the English language. Experienced employee benefits
specialist. Outstanding analytical abilities, organizational skills and detail


Benefits Specialist/HR Connections Specialist
Author of original articles and guides posted on intranet or published in compan
y newsletters

* Health and Wellness Resources Available through Health Plan Websites

* Coordination of Benefits (inc. Medicare)
* COBRA Continuation Coverage
* Medical Necessity/Medically Necessary
* Leave of Absence Q&A
* Health Care Reform/Initiative Legislation
* In-Network vs. Out-of-Network and Your Dollars ("UCR" and Balance Billing)
* HMOs vs. PPOs vs. EPOs
* Claims Appeals and Grievances
* The "Why" Behind Wellness
* Drug Formularies
* Pre-Existing Condition Coverage Limitations
* Produced Policies and Procedures (P&P) with regard to correcting shortfalls an
d over-deductions that occurred sporadically and became detectable in employees'
cumulative benefit premium payroll deduction amounts
* Served consultant role by providing analyses and resolution of escalated claim
s and eligibility issues associated with group medical, dental, life insurance,
accidental death and dismemberment insurance (AD&D) and Flexible Spending Accoun
t (FSA) plans
* Prepared quarterly risk management reports on behalf of Benefits and Compensat
ion Department ("HR Connections") of quality assurance (QA) activities to meet S
arbanes-Oxley (SOX) compliance requirements
* Produced PowerPoint training presentation on the subject of HIPAA Privacy and
Security Rules for Bank employees whose responsibilities bring them into contact
with Protected Health Information (PHI)
* Managed process improvement project with the goal of identifying inefficiencie
s, redundancies and sources of employee and manager confusion pertaining to the
administration of leaves of absence
* Participant in annual User Acceptance Testing (UAT) of the ADP hosted online b
enefits enrollment system used by the Bank in preparation for Annual Enrollment

* Created customized COBRA Election Notices for employees departing under unique
severance arrangements
* Participant in weekly teleconferences between the Bank and ADP for the identif
ication, discussion and resolution of issues arising from the interfaces between
the Bank's PeopleSoft personnel tracking system and ADP's payroll and benefits
* A principal Bank contact person for benefit vendor/carrier representatives
* Trained to perform accurate employee management data entry in PeopleSoft


Benefits Assistant (temporary assignment)
* Produced employee benefits training manual for company wide use by Tetra-Tech
human resources professionals across the United States


Corporate Benefits Coordinator
* Consultant to management, employees and JACOBS HR staff nationwide
* Provided assistance with complex problem resolution involving group health & w
elfare plans
* Corporate liaison for external consultants and key carrier contacts at numerou
s levels
* Developed instructional materials and trained HR staff on proprietary benefit
system input procedures involving benefit changes, correcting employees' YTD pre
mium accruals, new benefit plan set-ups, and adherence to U.S. Tax Code (Section
125) regulations and applicable respective plan provisions
* Audited samples of colleagues' benefit data system entries with respect to the
preceding point for QA
* Created detailed annual enrollment correspondence and forms provided to all CO
BRA participants and JACOBS Retiree Medical Plan enrollees
* Developed extensive online library of cover letters, forms and reference mater
ial pertaining to benefit administration; drafted numerous "special circumstance
" letters in response to individual employee inquiries and correspondence from o
utside attorneys
* Participated in developing Summary Plan Descriptions for JACOBS self insured m
edical plan
* Involved in implementing electronic eligibility file transmission process to g
roup medical plan administrator, performed weekly electronic FTP (file transfer
protocol) of employee FSA contributions, reviewed and corrected file deficiencie


Member Services Representative/Grievance Coordinator
* Liaison between CIGNA members (patients) and the medical and legal professiona
ls comprising the CIGNA Grievance (commercial group plan) and (Medicare) Appeals
* Assisted hundreds of patients with presenting appeals and grievances to the Co
* Prepared patient charts: wrote summaries of each case, including clinical info
rmation, case analyses, and applicable terms of patients' plans of coverage for
Committee review
* Communicated directly and effectively with medical professionals; extremely fa
miliar with medical terminology
* Presented each case to the Committees' physician Medical Directors, registered
nurses, executives and attorneys
* Arranged for patients to present their cases to the Committee, either in perso
n or via teleconference
* Prepared detailed Committee minutes
* Drafted formal letters employing technical medical and legal concepts and term
inology where applicable, approved by CIGNA attorneys and physicians for accurac
y and ease of comprehension, to communicate the Committee's final decision to ea
ch appellant patient
* Worked closely with attorneys; participated in representing CIGNA in court pro
* Responsible for ensuring medical staff and claims personnel acted upon Committ
ee decisions in a timely manner
* Developed quarterly trending analyses of Committee appeals decisions to identi
fy opportunities for process improvements at "lower" (pre-Committee) levels of r
* Created instructional modules and conducted training seminars for Member Servi
ces personnel on processing of patient grievances and appeals
* Involved in successful company bid to obtain full (3 year) National Committee
for Quality Assurance (NCQA) accreditation and meet Health Care Finance Administ
ration (Medicare, now "CMS") and California Department of Corporations (now DMC:
The Department of Managed Care) standards

B.A. - Anthropology (3.42/4.00 GPA)
The State University of New York at Albany
Minor/Emphasis: Sociology/Physics
Training - post graduate
Glendale Community College, Glendale, CA (Office Automation Computer Skills)
Monrovia Adult School, Monrovia, CA (Excel 2000)
Microsoft Word, Excel, PeopleSoft