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Ilka M. Ramirez
3354 Le Blanc  San Antonio, TX 78247
210-683-1010  imr1010@satx.rr.com
My objective is to obtain a position, in which I am given the opportunity to play a direct role in the
unlimited growth and success of a solid organization by developing a strong, motivated and engaged
team. I am a Self-motivated, dependable, energetic and effective leader who has the drive and
determination to consistently achieve success. At ease in high stress,fast-paced environments with
emerging and multiple responsibilities. I am an excellent team motivator with strong employee
development skills and a reputation as a hard worker who is focused on organizational goals and quality
performance.
Core Competencies
 Strong Leadership  Account Management  Team Oriented
 Employee Development  Performance Management  Process Improvement
 Project Management  Incentive Programs  Bilingual
 MS Office Proficiency  Strong Problem Solving Abilities  Cost Management
Professional Experience
TIA Group, LLC  Agency and PEO
Lead Account Manager  2014- Present
 Communication,Implementation,RFP process,and on-going Account Management fornew and existing
groups ranging in size of 2 lives up to 100+ for agency and PEO.
 Organize and participate as needed in open enrollment meetings.
 Lead complete new client implementation/renewalset-up and close-out including employee spreadsheet
and employer deduction files to a successful conclusion.
 Responsible for implementation of PEO accounts including set-up of Health Questionnaires.
 Maintain Open Enrollment material including Benefit Guides and Carrier material.
 Coordinate first month billing audits for new and existing client after implementation/renewal.
 Responsible for organizing 5500 and PCORI annual reporting.
 Create, organize and maintain and all client communication and updates.
 Resource for ongoing industry, current market and underwriting information.
 Responsible for maintain Client Service Timelines and Weekly Task Logs.
 Developed and maintain Benefits Departments Procedures Manual
 Spanish Translations as needed.
Frost Insurance, San Antonio, TX
Account Manager  2013
 Responsible for retention and management of 50+ Fully Insured and Self-Funded groups ranging from
small to large size accounts.
 Responsible for all renewal process of block of business.
 Coordination of Employee Communication, Implementation and on-going Account Management for
accounts.
BMA, Inc.,San Antonio, TX
Manager - Service and Operations  2012 - 2013
 Responsible for day-to-day management of Operations team including inventory, quality, work load,
schedules and metric performance for Claims, Customer Service, Flex and Provider Ads Teams.
 Develop Performance Reports for key Operational positions (Customer Service, Claims and Flex
Analyst)
 Responsible for Provider Appeals and Medical Necessity reviews.
 Developed and maintain Client issues log for top accounts.
Benefit Planners / United HealthCare / UMR, San Antonio, TX
Director - Service and Operations 2000-2012
 Provide ongoing operations leadership, guidance and direction including performance management,
inventory management, quality assurance, member satisfaction, and financial disciplines for
Claims/Customer Service center with approximately 175 employees.
 Responsibilities included establishing performance metrics for all operations teams including claims,
customer service and all support departments.
 Experience with IEX technology to schedule and forecast member calls. Responsible for obtaining
customer service call metrics (30 seconds ASA, 5:00 call duration)
 Accountable for major expense reduction projects including full platform migration and global
outsourcing initiatives.
 Executive relationship management of top revenue accounts.
 Responsible for enrollment process of over 350 clients including ID card maintenance.
 COBRA and Flex Administration
 Developed high performance employees through performance management, goals and expectations.
 Lead Operations Excellence Six Sigma project to reduce increase productivity.
 Incentive compensation programs for productivity based positions
Continuous Educations
 Texas Life and Health License
 Data Confidentiality
 Code of Conduct and Policy Attestation
 Fraud, Waste and Abuse Training
 Privacy and Security Training
 The Managers Role in Affirmative Action
 HIPAA Individual Rights
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Sr. Account Management March 2016

  • 1. Ilka M. Ramirez 3354 Le Blanc San Antonio, TX 78247 210-683-1010 imr1010@satx.rr.com My objective is to obtain a position, in which I am given the opportunity to play a direct role in the unlimited growth and success of a solid organization by developing a strong, motivated and engaged team. I am a Self-motivated, dependable, energetic and effective leader who has the drive and determination to consistently achieve success. At ease in high stress,fast-paced environments with emerging and multiple responsibilities. I am an excellent team motivator with strong employee development skills and a reputation as a hard worker who is focused on organizational goals and quality performance. Core Competencies Strong Leadership Account Management Team Oriented Employee Development Performance Management Process Improvement Project Management Incentive Programs Bilingual MS Office Proficiency Strong Problem Solving Abilities Cost Management Professional Experience TIA Group, LLC Agency and PEO Lead Account Manager 2014- Present Communication,Implementation,RFP process,and on-going Account Management fornew and existing groups ranging in size of 2 lives up to 100+ for agency and PEO. Organize and participate as needed in open enrollment meetings. Lead complete new client implementation/renewalset-up and close-out including employee spreadsheet and employer deduction files to a successful conclusion. Responsible for implementation of PEO accounts including set-up of Health Questionnaires. Maintain Open Enrollment material including Benefit Guides and Carrier material. Coordinate first month billing audits for new and existing client after implementation/renewal. Responsible for organizing 5500 and PCORI annual reporting. Create, organize and maintain and all client communication and updates. Resource for ongoing industry, current market and underwriting information. Responsible for maintain Client Service Timelines and Weekly Task Logs. Developed and maintain Benefits Departments Procedures Manual Spanish Translations as needed. Frost Insurance, San Antonio, TX Account Manager 2013 Responsible for retention and management of 50+ Fully Insured and Self-Funded groups ranging from small to large size accounts. Responsible for all renewal process of block of business.
  • 2. Coordination of Employee Communication, Implementation and on-going Account Management for accounts. BMA, Inc.,San Antonio, TX Manager - Service and Operations 2012 - 2013 Responsible for day-to-day management of Operations team including inventory, quality, work load, schedules and metric performance for Claims, Customer Service, Flex and Provider Ads Teams. Develop Performance Reports for key Operational positions (Customer Service, Claims and Flex Analyst) Responsible for Provider Appeals and Medical Necessity reviews. Developed and maintain Client issues log for top accounts. Benefit Planners / United HealthCare / UMR, San Antonio, TX Director - Service and Operations 2000-2012 Provide ongoing operations leadership, guidance and direction including performance management, inventory management, quality assurance, member satisfaction, and financial disciplines for Claims/Customer Service center with approximately 175 employees. Responsibilities included establishing performance metrics for all operations teams including claims, customer service and all support departments. Experience with IEX technology to schedule and forecast member calls. Responsible for obtaining customer service call metrics (30 seconds ASA, 5:00 call duration) Accountable for major expense reduction projects including full platform migration and global outsourcing initiatives. Executive relationship management of top revenue accounts. Responsible for enrollment process of over 350 clients including ID card maintenance. COBRA and Flex Administration Developed high performance employees through performance management, goals and expectations. Lead Operations Excellence Six Sigma project to reduce increase productivity. Incentive compensation programs for productivity based positions Continuous Educations Texas Life and Health License Data Confidentiality Code of Conduct and Policy Attestation Fraud, Waste and Abuse Training Privacy and Security Training The Managers Role in Affirmative Action HIPAA Individual Rights