Highly motivated Sales Associate with extensive customer service and sales experience. Outgoing sales professional with track record of driving increased sales, improving buying experience and elevating company profile with target market.
Under general supervision, review, research, analyze, and evaluate the corporate and client benefits plans.
Responsible for the administration of all disability policies to include FMLA, ADA, Work Compensation, OHSA logs and other leave plans.
Manage leave plans for 3 business entities from concept to implementation with FMLA review and determination done in-house.
Function as the liaison between vendors and employees.
Advise employees on eligibility and coverage related to leave of absence, ADA accommodation, and other benefit matters.
Assist with compliance and other regulatory interpretations and audits.
Review and analyze leave of absence trends for monthly reporting.
Prepare and analyze leave of absence and workers compensation reports and metrics.
Lead and coach team members, HRBP's and managers on leave of absence regulations and guideline related to leave of absence, fitness for duty, and ADA accommodation decisions.
Responsible for managing the interactive accommodation review process and deciding appropriate reasonable accommodations for employees with restrictions and limitations request/needs.
Stay abreast on applicable legislation and regulations pertaining to FMLA and ADA.
Conduct monthly LOA/WC training for managers to meet training and compliance requirements for 3 separate business entities.
Assist with creation of templates, policies, procedures and forms for restructuring of leave of absence administration and compliance.
Provide weekly LOA payroll reporting for reconciliation of payroll processing for those employees on continuous or intermittent leave.
Communicate benefit premiums to employees on leave for payment processing and maintenance.
Other duties to include providing back up to other areas within the HR/Benefits department.
Administer FMLA and Short term disability, military and personal LOA functions.
Manage the interactive accommodations review process to ensure ADA guidelines/regulation is adhered to for associates that require accommodations.
Consult and advise associates on benefit related inquires/issues.
Handle escalated matters related to leave of absence, payroll, benefit deductions/issues and accommodation review process.
Work closely with Risk Management and Employee Relations on leave of absence and worker's compensation issues to resolution.
Run daily metric reporting, serve as subject matter expert on all LOA related issues.
Verify calculations of monthly premiums statements for all group insurance policies.
Administer benefit plans including maintenance of benefit enrollment system, monthly billing processing and reconciliations, and monitor compliance of employee benefits programs will all legal requirements (COBRA, FMLA, ADA, HIPAA, etc.) Help with the coordination and administration of annual open enrollment process.
Assist with the planning of annual benefits fair and open enrollment information sessions.
Respond, research, and answer departmental email receipt.
Other projects and duties as assigned.
Contract Specialist, 09/2012 - 01/2013 Humana – City, STATE,
Responsible for review and process of Medicare approved plans and options to existing and new contracts to the network by applying technical expertise for solving complex problems.
Review and research of conflicting contract data by using interactive reporting, adhoc exception reports and internally created inventory reports.
Maintain current processing standards of all new and existing contract data within established department metrics of 99.7% QA score.
Assist with special projects as identified by manager.
FMLA Group Claims Associate, 06/2009 - 09/2012 Cigna Leave Solutions – City, STATE,
Manage disability claim caseload for various clients (500-800 ongoing open cases) within contractual agreements for short/long term disability benefits concurrent with FMLA and state leave regulations.
Determine eligibility requirements are met and communicate to claimant in writing and via telephone.
Input claimant medical and demographic data evaluating eligibility of federal and state leaves.
Address obstacles with claimant, attending physician and employer; monitor claimant's medical conditions, discuss claimant's work return with employer; integrate individual rehab/return to work plans into ongoing medical treatment; monitor other state disability income benefits; decide payment period's accuracy and timeliness; follow claimant's leave to closure.
Respond to client and external vendor inquiries with time standards; evaluate absence while reviewing all medical information and determine claim approval or denial while adhering to all legal/compliance requirements for short-term/long-term disability and FMLA benefits.
Maintain FMLA and absence in claim system, including comprehensive and detailed paperwork to evaluate and assess claim processing and medical treatment plan.
Maintain mandatory quality standard of 95% or better and meet 100% compliance/production standard.
HR Representative III, 07/2008 - 05/2009 Northrop Grumman – City, STATE,
Work closely with corporate sector, managers and HRBPs, to successfully build organizational and managerial abilities utilizing influence, coaching and SOCS training.
Provide HR support to over 1200 employees; support other sectors throughout the company, as directed, drawing upon varied personal skills.
Build strong partnerships to align business objectives, work culture, HR policies and procedures.
Integrate and educate all managers and employees on human resources policies and procedures to include: STD, LTD, FMLA and ADA.
Effectively influence the execution of performance management/talent assessment, employee relations/counseling, employee development and team building.
Resolve employee relations issues concerning ethics complaints and investigations.
Provide HR support to severance employees.
Assist and lead local/divisional projects.
Maintain business partnership with all levels of management and staff.
Meet and exceed business directed HR goals.
Obtain necessary PeopleSoft 9.0 certification to access and adjust personnel files and complete transactions.
Took responsibility for calculating and updating national benefit claims for over 275,000 employees.
Proficiently use PeopleSoft and Remedy HR payroll systems.
Maintain and reconcile payroll discrepancies for all short term/long term, Family Medical Leave Act (FMLA), and Worker's Compensation disability claims.
Be liaison to HR managers, legal department, external vendors, and employees.
Assist payroll and HR departments as needed by processing employees up to termination within departmental guidelines, reconciliation of payroll overpayments.
Assist employee and HR with paycheck discrepancies.
Process all leave management correspondence to include Worker's Compensation and STD wage verification.
Serve employees as alternate payroll customer service representative with inquiries and issues encompassing garnishments, vacation pay, direct deposit and various payroll inquiries.
Education
Certified Professional Disability Management (CPDM) - in pursuit
Insurance Education Association (IEA): , Expected in - Northwood University - , GPA:
BBA: Business Management, Expected in - - , GPA: Business Management
AAS: , Expected in - Tarrant County College - , GPA:
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School Attended
Northwood University
Tarrant County College
Job Titles Held:
Benefits Analyst II/LOA Specialist
Benefits Specialist
Contract Specialist
FMLA Group Claims Associate
HR Representative III
Disability Payroll Advisor
Degrees
Certified Professional Disability Management (CPDM) - in pursuit
Insurance Education Association (IEA)
