Susan Sheltra

Manage ongoing client and carrier relationships, ensuring accurate benefit administration and timely resolution of service inquiries. Analyze data across D365 and multiple carrier portals to identify eligibility, billing, and system discrepancies. Partner with Benefit Consultants to support renewals, employer education, and system updates. Monitor service levels and follow up with internal teams and carriers to meet SLAs and contractual obligations. Provide employer guidance using compliance tools, carrier resources, and benefit administration platforms.

Delivered end-to-end administration support for assigned group benefit accounts, maintaining high client satisfaction and retention. Served as primary point of contact for employers, agents, and internal teams regarding eligibility, billing, and policy maintenance. Interpreted data across multiple systems to identify trends and root causes impacting plan administration. Educated employers, agents, and wholesalers on product administration, enrollment processes, and system navigation. Supported marketing and enrollment initiatives through reporting, documentation, and reenrollment materials.

Led implementation and ongoing administration of pharmacy benefit plans, ensuring eligibility, claims, and billing accuracy. Built trusted relationships with clients, agents, and TPAs to support consistent service delivery. Analyzed Rx utilization data to provide actionable insights for short- and long-term client strategies. Supported renewals and mid-year plan changes, contributing to client retention. Represented the organization at benefit fairs and open enrollment events.

Managed onboarding, renewals, and daily service operations for collegiate health insurance programs. Served as primary liaison between colleges, brokers, carriers, and internal departments. Coordinated escalated service and claims issues through resolution. Collaborated with IT and project teams to implement client-specific plan requirements and web solutions. Presented health plans to student populations and institutional stakeholders.

Supported strategic planning for large-group fully insured and self-funded benefit programs. Acted as liaison between clients and carriers to ensure accurate plan design and documentation. Developed customized employee communications for open enrollment and compliance initiatives. Evaluated carrier proposals and supported plan recommendations. Resolved complex eligibility, billing, and claims issues in high-volume environments.