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gwendolyn
US-Pennsylvania-Philadelphia
PRODUCT ANALYST
NEW CAREER START WITH AN UP AND COMING COMPANY THAT OFFERS ROOM FOR ADVANCEMENT IN EXCHANGE FOR HARD WORK.
GWENDOLYN R. HALL
212 Heather Road ● Upper Darby, PA. 19082
610.713.9532
610.713.0467(fax) 610.952.0560 (cell)
Eye12dance@comcast.net
PROFESSIONAL EXPERIENCE:
Philadelphia Eagles/Lincoln Financial Field
Usher/Usher Supervisor/Tickettaker Sept. 2003 – Sept. 2005
• Provide the highest quality level of sports entertainment to the public
Weichert Realtors October 2004 – April 2007
Media, Pennsylvania
Realtor
• Pennsylvania Licensed Real Estate Salesperson.
• Graduate, Weichert Real Estate Academy
Independence Blue Cross, Philadelphia, PA
Product Analyst January 1997 - Present
• Ensure regulatory compliance and provide contract and benefit interpretation for the HMO product. (previously done for the Medicare Division)
• Partner with Product Managers and other business departments to develop work plans and recommendations for filings and company initiatives, including state transmittal forms.
• Ensure that filings are free from substantive errors prior to mailing..
• Submit regulatory compliance filings to Delaware, New Jersey and Pennsylvania insurance departments.
• Submit completed filings to designated area and follow-up and communicate state filing status and prepare all fulfillment documents for groups and members.
• Prepare and submit annual state reports.
• At direction of and in consultation with product managers, pro-actively provide technical guidance and consultation in creating insurance forms.
• Provide project management support.
• Respond to inquiries from the Departments of Insurance.
• Manage special projects.
• Account Management.
• Research Medical policy in relation to our contracts.
• Work closely with Legal department on the filing of state mandates.
• Draft, proofread and audit group and member forms in preparation for state regulatory submission and filing.
• Develop and maintain state specific Benefit Manuals.
• Provide diversified support to the Manager and Supervisor of Product Analysis and Compliance.
• Analyze and interpret enacted state and federal HMO laws and regulations
in order to determine the impact to existing products.
Retiree Consultant/Technical Advisor 1996 - 1997
• Service pre-member inbound calls.
• Conduct new member outbound orientation calls.
• Complete product request forms.
• Assist reps with technical advising on inbound calls.
• Conduct offsite group orientations.
• Miscellaneous duties as required: reviewing applications, outreach calls,
assist in Walk-In Department window when necessary, assist Management
and co-workers as needed, systems training, Acting Technical Advisor/Supervisor duties, prepare reports.
Member Service Representative 1994 - 1996
• Service member calls (group and non-group accounts) for all lines of business.
• Research and process claims for payment or adjustments.
• Supervise and train new Member Service Representatives.
• Mentor and evaluate new employees.
• Acting Technical Advisor
Joseph Rothbard & Co., Philadelphia, PA 1987 – 1994
Customer Service Representative/Project Coordinator
• Review furniture specifications.
• Place, process and track contract furniture orders.
• Coordinate customer deliveries and installations.
• Maintain inventory lists.
• Act as a liaison between the customer and in-house staff.
(Projects: Waste Management, Graduate Health Systems,
Independence Blue Cross, Conrail, U.S. District Court, Arco Chemical)
Delaware County Memorial Hospital, Lansdowne, PA 1992 – 1993
Pharmacy Technician
All duties associated with the operation of the pharmacy including assisting the Pharmacist in the dispensing of medication.
EMT Ambulance Company, Havertown, PA 1991 – 1993
Emergency Medical Technician
State certified to transport and treat patients for basic life support.
J.C. Penney Company, Upper Darby, PA 1986 – 1991
Store Detective
Investigations, arrests and prosecution of shoplifters, including employees.
Paul J. Paris Detective Agency, Croydon, PA 1984 – 1986
Private Investigator
Surveillance, interviews, subpoena serving, preparation and filing of court documents.
Philadelphia Police Department, Philadelphia, PA 1982 – 1984
Police Officer
Routine street patrol, court appearances and special assignments, 18th District, 55th and Pine Streets, Philadelphia, Pennsylvania.
Mellon Bank, Philadelphia, PA 1977 – 1982
Tax Accountant
Preparation of taxes for trusts and estates.
Fiduciary Accountant
Preparation of financial accountings and statements for trusts and estates.
Secretary
Office Management (including typing, filing and miscellaneous duties.
COMPUTER TRAINING:
Microsoft Office, Windows XP, Internet/Intranet
ACCOMPLISHMENTS/CERTIFICATIONS:
Six Time Gold Coin Winner for Quality Achievement.
Customer Service Blue Diamond Award Winner.
Medicare Champion Project.
Quality Work Group (Career and Skill Development)
Crisis Call Management Training (Green Springs)
Total Quality Management (Quality Work Group Education).
Teleservicing Skills Training.
Independence Blue Cross, 2002 Best of the Best
2004 Gold Coin Award (High Cost Radiology Project)
2008 Gold Coin Winner for United Way Bluesteppers Performance
EDUCATION:
Rosemont College Graduated 1997
B.S. in Management
Saint Joseph’s University M.S. in Health Administration
(1 year completed)
University of Phoenix MBA candidate
References: References available upon request.
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