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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Results-oriented FMLA Leave Specialist, energetic, results-oriented team-player eager to bring strong FMLA Leave benefits to a growing company in need of top-level support.with excellent organization, communication and relationship-building skills.


Core Qualifications
  • Self-starter
  • Deadline-oriented
  • Problem resolution
  • Strong organizational skills
  • Courteous demeanor
  • Maintains strict confidentiality
  • Team player with positive attitude
  • Good written communication
  • People-oriented
  • New employee orientations
  • Training and development
  • Knowledge of HMOs, Medicare and Medi-Cal
  • Strong planning skills
  • Microsoft Office proficiency
Experience
Leave Specialist, 08/2013 - Current
James Avery Jewelry Bee Cave, TX,
  • Assist with organizational compliance with applicable federal and state regulations (COBRA, HIPAA, FMLA, ADA, ERISA) Ensure confidentiality of all medical information, preventing release of information to unauthorized parties.
  • Provide excellent customer service and serve as liaison between vendors and employees.
  • Focused, results-oriented professional experience in progressively responsible positions providing a positive, professional impression for guests and staff, conveying a sense of exceptional customer service, both proactive and reactive.
  • Perform other duties as assigned.
  • Demonstrated ability to gather/analyze information to make decisions from multiple sources, including: employees, medical providers, federal/state regulations, department policies/procedures, and customer service level agreements with using department-specific applications to document activities and manage/complete tasks in accordance with quality and timeliness protocols.
  • Ensure receipt and appropriateness of medical documentation and other documentation to support leave determination with coordinates all FMLA, LOA, Paternity, Military, Personal, Company Own medical documentation with all employee communications, notifications and tracks all leave activity with maintaining employee leave files.
  • Respond to inquiries from customers and their employees, research and resolve leave-related issues or escalate to next level with the ability to interact with internal and external customers through communicating with tact, diplomacy, professionalism, and sensitivity in all interactions.
  • Knowledge of department of Labor regulations for state specific regulations, and customer-defined leaves but not limited to Maternity, Military, Paternity, Family Care, Bonding, Bereavement, Own disability, Company own medical, Personal leaves or absence policies as a safety sensitive position, able to hear and speak with others in-person or on the phone.
  • Strong computer skills in System one, data entry, basic MS Word, MS Excel, MS Outlook.
  • Instant Messenger, Internet.
  • Experience in benefits administration or disability claims.
  • Assist senior leave specialist with e-mail in box responsibilities, training, review, guidance as requested in absence of the senior leave specialist.
  • Mentoring new hires for readiness to perform the essential job functions as required by management.
  • Excellent organizational skills to manage multiple priorities and tasks for 1200 plus caseload.
  • Excellent telephonic communication and customer service skills to solicit information and convey decisions to a variety of audiences clearly, succinctly and diplomatically.
  • Consistently use of applicable business process documentations such as job aide, check lists, fact training manuals and department bulletins.
  • Effective partnership with claims case manager counterparts and participation in department cross training meetings and initiative with the ability to maintain a high level of confidentiality.
Human Resource Leave of Absence Administrator III, 07/2008 - 05/2013
Building Controls And Services Wichita, KS,
  • Case management for leave administration encompassing all leave transactions with FMLA, LOA, ADA, HIPAA, & COBRA laws and administration with basic knowledge of 401 (k) plans and understanding relationship between HR and Payroll.
  • Responsible for employee education of company benefits programs and policy to all employees, ensuring timely and accurate enrollment or changes.
  • Works closely with Payroll and external disability benefit vendors to ensure accurate tracking and pay of employees on LOA.
  • Handles the day-today administration of all health benefits, Leave of Absence, COBRA programs and recommends modifications.
  • Leave Termination for Worker's Compensation Furlough Death Administration Short-Term Disability Family and Medical Leave (FMLA) Long-term Disability Personal Leave Return-to-Work including (restricted duty) Military Leave.
  • Ability to maintain a high level of confidentiality.
  • Investigate inquiries and issues Investigate inquiries and issues providing resolution or escalation, as needed working effectively in a high-volume environment subject to changing priorities and short deadlines Proven experience administering a variety of different Leave and Disability benefits.
HR Benefits Specialist, 2008 - 06/2008
Leidos Holdings Inc. Reston, VA,
  • Ensures accuracy of all benefits enrollment and leave information in the HRIS, validating the vendors have accurate benefits and leave data.
  • Administer employee benefits including health, prescription, vision, dental, life insurance, retirement, and flexible spending accounts.
  • Responsible for assisting in coordinating a smooth transition of open enrollment periods in accordance with all legal requirements.
  • Inputs benefit elections/deductions into HRIS system and audit for accuracy and integrity of information.
  • Implements and administers assigned program responsibilities; conducts research; analyzes data and prepares reports; assists employees with benefit enrollment website issues; and oversees all benefits.
  • Assist with organizational compliance with applicable federal and state regulations.
  • Coordinates open enrollment and new hire enrollment processes with internal and external resources.
  • Acts as representative to all employees for new hire information, prepares and maintains employee benefits files.
  • Serve as liaison between vendors and employees with providing excellent customer service.
  • Assists employees and business partners with questions related to benefits and leave of absence administration.
  • Attention to details and accuracy while maintaining Ability to maintain a high level of confidentiality and initiative problem solving.
Customer Service Specialist, 03/2007 - 11/2008
The Shyft Group, Inc. Waterville, ME,
  • Handled large inbound/outbound volume of calls in the health insurance industry.
  • Scheduled home inspection appointments to obtain the current market value for home, property resale.
Team Lead, 02/2002 - 03/2007
Schaller Anderson City, STATE,
  • Worked with insurance companies to obtain benefit information.
  • Resolved escalated claims for benefit level, third party liability, over payments, inappropriate coding with high resolution of disputes, complaints, and discrepancies for a team of 12 employees.
Member, Provider Relations Administrator, 06/1999 - 03/2002
First Health City, STATE,
  • Performed claim adjustments, investigated claims and provided telephone coverage for customer service department.
  • Collecting co-pays.
  • High call volume from members and providers.
  • Proved ability to interact effectively with clients and staff at all levels.
  • Demonstrated ability to gain account loyalty.
Education
Associate Degree: Paralegal, Expected in 2005
-
Lamson College - Tempe, AZ
GPA:

Coursework in Paralegal Law

Professional Affiliations
Skills

ADA, administrative, basic, Benefits, benefits administration, business process, case manager, Case management, CPR, clients, excellent customer service, customer service, customer service skills, data entry, delivery, documentation, e-mail, employee communications, First Aid, HRIS, HR, inspection, insurance, interpretation, legal, market, meetings, Mentor, Mentoring, MS Excel, MS Outlook, MS Word, Works, next, organizational skills, organizational, Payroll, policies, problem solving, processes, coding, protocols, quality, research, safety, telephone, phone, training manuals, vision, website

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School Attended

  • Lamson College

Job Titles Held:

  • Leave Specialist
  • Human Resource Leave of Absence Administrator III
  • HR Benefits Specialist
  • Customer Service Specialist
  • Team Lead
  • Member, Provider Relations Administrator

Degrees

  • Associate Degree

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