- Researched Medicare coverage database
- Determined coverage for medical services within Medicare guidelines and Sterling benefit plans
- Configured codes in the database
- Inquired and resolved a high volume of claims on a daily basis
- Processed grievances and appeals
- Liaised with other departments to resolve claims issues
senior benefits analyst
- Responsible for third-party administrators, carriers and benefit vendor relationships.
- Led annual enrollment process, including coordinating renewal activities through multiple vendors, project management of system set-up and programming, perparing cost-sharing strategy and overseeing design, development and distribution of communication materials.
- Supported labor negotiations by providing analysis, costing and recommendations.
- Managed multiple vendor RFP processes through selection and implementation; managed implementation of COBRA and Benefits Billing module in PeopleSoft.
- Responsible for Sarbanes-Oxley compliance review of benefit plan procedures, designed and implemented HIPAA policy and procedures.
- Executing all phases of the sales cycle
- Advising potential customers on the appropriate insurance product based on their specific needs, industry experience and their medical history
- Demonstrating deep knowledge of health insurance products in the UAE
- Communicating unique selling points of Bayzat to clients
- Liaising with insurers to streamline policy acquisition
- Liaising with insurers on behalf of clients to ensure communicated benefits of policies are maintained
- Providing feedback to Bayzat on client experiences with different health insurance products
- Ability to read client plan(s) and provisions and translates to the ongoing processing environment.
- Responsible for administering open enrollment, including design of process, employee communication, coordinating with providers for electronic eligibility files, and working with payroll department to ensure accurate payroll deductions.
- Provides health & welfare benefit conceptual & technical guidance and support to service associates to resolve product and client issues by utilizing extensive product knowledge, problem solving skills and troubleshooting experience.
- Researches Plan Rules to ensure compliance and to resolve plan administration questions/issues resulting from audit.
- Works with the client, 3rd parties, Shared Services, Customer Service and the Implementation
- Delivery Group to resolve participant and plan administration issues.
- Manages inbound/outbound data quality checks, executes year-end processing, and reporting (government, plan, client, internal team etc.)
- Providing feedback to the tech team on performance of web and mobile platforms of Bayzat Benefits
- Effective management of sales pipeline in order to maximise revenue potential
- Exercising sales and people skills in order to meet revenue targets
- Identifies potential production defects and submits via defect submission process.
- Supports Benefits Delivery Manager in managing costs through process improvements and by performing financial management activities. Completes reconciliations/balancing, and performs processing verification.
- Advises on the training efforts for Customer Service associates, Shared Services, Global Delivery Teams, and for new associates joining team,