Constance M.

About Constance M.

I’m a Medicare certified professional with Fraud, Waste & Abuse training and a strong background in documentation, accuracy, and regulated processes. After years of supporting Medicare members, navigating CMS guidelines, and maintaining strict compliance, I am transitioning into claims, compliance, benefits operations, and other non-phone healthcare roles where precision and quality matter.I’m skilled in: Medicare regulations, HIPAA & FWA compliance, Claims documentation, Case review & problem-solving, System navigation, Member data accuracy, High-stakes decision support, I’m looking for opportunities where I can use my strengths in detail, organization, regulated workflows, and accuracy to support operations, claims, compliance, or administrative teams within healthcare or insurance environments.I bring professionalism, adaptability, and a calm, steady approach to complex tasks — and I am excited about the next chapter of my career.I’m passionate about creating workplaces where employees feel supported, informed, and valued. My goal is to leverage my skills in benefits, wellness, and compliance to help organizations strengthen their people strategies and deliver measurable results.

Experience

1. Insurance Sales Representative

   Bcbs Association

   Jan 2022 — Present

   Conducted identity verification and reviewed insurance applications for red flags, preventing 30+ instances of fraud.Resolved complex account issues in coordination with underwriting, compliance, and fraud units.Enhanced case documentation accuracy to 98% in Salesforce while managing high-volume operations.

Education

• The College of New Rochelle

  Bachelor of Science (B.S.), Communications

  1997 — 2001

• College of New Rochelle

  Bachelor of Arts in Communications

Skills

• Cobra
• Leadership
• Std
• Employee Benefits
• Notary
• Leave of Absence
• Heath and Welfare
• Customer Service
• Talent Management
• Quality Control
• People Soft
• Ltd
• Employee Relations
• Human Resources
• Work Number
• Team Mentoring
• Open Enrollment
• Peoplesoft
• Siebel
• Peoplesoft 8.0/Hris,
• L&D Net
• Sharepoint
• Training
• Sap
• Accounts Payable & Receivable
• Performance Management
• Management
• Sabre
• Microsoft Office Components
• Quickbooks
• Windows Xp
• Cs Pro
• Team Meetings
• Windows Vista,
• Recruiting
• Project Gaap Reporting
• Quality Assurance
• Pensions
• Onboarding
• Benefits Administration