Misty A. Moseley

1209 Oak Street
McKinney, TX 75069 
(214) 544-0011 Work/Home Number
(214) 585-1999 Cell Number

Objective
Secure a position within Risk Management that compliments my experience and
provides opportunity for career advancement. 

I offer seventeen years of experience in the field of Risk Management including
thorough knowledge of insurance products and self-funded/TPA administration. My
work experience covers the gamut of front line customer interface at the group
executive level to the member level, contract issuance, case installation of
benefits, and business operations. I have a comprehensive knowledge of
contractual interpretation as it relates to system integration and end user
groups both internal and external. 
 
Experience
2001-Present 
UnitedHealth Group Incorporated 
Plano, TX

Operations
Project Management
Business Process Specialist

Produced operational models for implementation process for the Key Account
business segment (i.e. groups with 50 to 4 thousand lives) for upper management.

Developed product integration plans for system support of all major/minor
contractual filings including medical, vision, and consumer driven products.

Intermediary relation with Product, Contract Specialist and UT. I have
developed, maintained, enhanced and tested all generic internet templates that
are utilized to build over 50,000 customer specific internet accessed documents
for members. I have developed, maintained, enhanced and tested all generic
templates utilized by the case installation department for building benefits on
UNET.
 
 
1999-2001 
UnitedHealth Group Incorporated 
Plano, TX

Operations
Case Installation Department
Senior Analyst

Responsible for benefit build of 120 accounts primarily focused on the Colorado
and Texas markets with a mixture of Strategic Accounts (i.e. groups of 4 thousand
or more lives.)

Required complete knowledge of all standard UHG product offerings, legislative
mandates for Texas and Colorado mandatory versus mandatory offerings to
facilitate compliance of benefit build on the UNET system.

System compatibility reports for RFP’s.
 
 
1998-1999 
UnitedHealth Group Incorporated 
Plano, TX

Operations
Contract Issuance Department
Senior Contract Administrator

Responsible for production of all riders, amendments, certificates of coverage,
summary plan descriptions, financial renewal agreements, administrative services
agreements and comparative analysis of externally produced summary plan
descriptions for groups that produced their own documents.

Contractual compatibility analysis for RFP’s.
 
1994-1998 
CENTRA Benefit Services, Inc. 
Plano, TX

Third Party Administration
Member Services
Customer Advocate

Responsible for 115 calls per day, complex claim adjustments and audits.

Required knowledge, ICD-9, HCPCS, Revenue codes on UB92 forms and HICFA 1500
billing.

1993-1994 
Confed Admin Services, Inc. 
Tucson, AZ

Third Party Administration
Member Services
Customer Advocate

Responsible for 115 calls per day, complex claim adjustments and audits.

Required knowledge, ICD-9, HCPCS, Revenue codes on UB92 forms and HICFA 1500
billing.
 
Education
1992 University of Arizona Tucson, AZ

B.A., International Relations and American Foreign Policy

 
 
Interests
Landscaping, interior design, snorkeling, camping, hiking, and antiques.