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dls case manager resume example with 19+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Summary

Accomplished Case Manager and Human Resources Representative adept at handling high caseloads without sacrificing quality of care. Operates exceptionally well in high-pressure environments. Recommends best resources and courses of action to benefit patient needs and return each to optimal quality of life.

Skills
  • Experience providing case management services for a large, multi-state employer or on behalf of a carrier/TPA with clients in multiple states
  • Experience with global service and employee delivery
  • Exceptional customer service and communication skills, both verbal and in writing
  • Strong problem solving, time management and priority setting skills
  • Experience providing guidance to employees or managers on leave of absence, disability plan, accommodation, human resources, benefits, or employee matters
  • Experience working with confidential information
Experience
DLS Case Manager , 11/2017 - 04/2021
Amazon.Com, Inc. Cerritos, CA,
  • Initiate and respond to inquiries about leave and disability events, benefits, and options available to employees
  • Provided case management for all types of leave and disability ie: Terminal illnesses, catastrophic, mental health. As well as assisting with cases of fellow Corporate employees and upper level management ie: L5-L8.
  • Serve as a point of contact for assigned employees (150-200 employee cases; often more) to provide holistic case management services, including reviewing medical documentation to adjudicate leaves in compliance with the corresponding leave plans, federal and state laws and benefit plans.
  • Leverage duration guidelines, best practice tools and Amazon resources to support oversight of a leave event as appropriate
  • Critically assess and adjust the case management plan to an employee’s changing needs
  • Address and respond to sensitive situations
  • Troubleshoot issues and seek to remove barriers before, during, or after a leave event
  • Respond to employee impacting issues that may arise during the leave event and ensure the right communication occurs
  • Identify and solve problems that may arise, sometimes with limited information
  • Facilitate a smooth return to work and ramp-back plan for employees returning to the workplace
  • Educate managers and business partners on employee concerns and needs prior to being off or returning back to work
  • Communicate regular updates to employees and stakeholders both verbally and in writing
  • Ensure compliance with standard work, federal/state regulations, and company policy
  • Maintain system records to ensure accurate and timely information/documentation
  • Consult, coordinate and partner with our third party administrator, HR, Safety, Legal, Payroll, Benefits, team members and other departments/systems as appropriate
  • Transition employees to the Long Term Disability and Social Security aspects of disability if necessary
Corporate HR Shared Sevices Specialist, 11/2012 - 11/2017
Turnberry Associates Nashville, TN,
  • FMLA process start to finish
  • Return to work process
  • Return to work with accommodations
  • ADA Interactive Process
  • USSERA
  • Multiple State Disability Leave/Maternity Plans - NV, NJ, CA, IA, LA
  • Various Union benefits throughout the state of Nevada
  • Reed Leave Pro
  • Electronic Records Management
  • HRIS
  • Employee engagement
  • Benefit administration
  • Employee Labor relations
  • Payroll processing
  • Verification of employment
  • Educational Assistance Program
Insurance Verification and Prior Auth Specialist , 07/2009 - 11/2012
Preferred Homecare City, STATE,
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
  • Updated all patient and insurance data regularly and carefully inputted changes into company's computer system.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Followed specific security rules and guidelines to protect sensitive data, including patient medical records and payment card information.
  • Adhered to all HIPAA requirements to safeguard patient confidentiality.
  • Communicated with patients to gather intake data and verify chart information.
  • Managed incoming telephone calls, including taking messages and directing callers to personnel.
  • Identified important patient and demographic information.
  • Performed verification of Medicare coverage.
  • Signed payment approvals accepted claims.
  • Pulled patient files and forwarded to appropriate offices for processing.
  • Created and maintained accurate and confidential patient files according to regulatory mandates.
Front Desk Supervisor, 01/2002 - 07/2009
Regis Signature Salon City, STATE,
  • Handled payment processing and provided customers with receipts and proper bills and change.
  • Managed guest check-in and check-out procedures, reservations and payments.
  • Managed customer complaints and rectified issues to complete satisfaction.
  • Mentored new staff on correct procedures, compliance requirements and performance strategies.
  • Addressed and welcomed large volume of guests to business per day, improving overall customer service and engagement.
  • Directed all front desk operations staff productivity and operational efficiency.
  • Arranged special accommodations for guests to maintain optimal satisfaction.
  • Maintained and ordered all inventory for the salon(s)
Education and Training
: Medical Assisting, Expected in
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Kaplan College - Las Vegas, NV
GPA:
Status -
: , Expected in
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FMLA/ Department of Labor/ Employment Laws - Las Vegas, NV
GPA:
Status -
: , Expected in
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Microsoft/Excel Ongoing Education - ,
GPA:
Status -

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Resume Overview

School Attended

  • Kaplan College
  • FMLA/ Department of Labor/ Employment Laws
  • Microsoft/Excel Ongoing Education

Job Titles Held:

  • DLS Case Manager
  • Corporate HR Shared Sevices Specialist
  • Insurance Verification and Prior Auth Specialist
  • Front Desk Supervisor

Degrees

  • Some College (No Degree)

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