sr disability case manager resume example with 10+ years of experience

(555) 432-1000,
, , 100 Montgomery St. 10th Floor
Professional Summary

Eight plus years experienced in disability and absence management. Efficient in managing complex claims and high priority project without sacrificing quality of care. Operate in high-pressure environments while recommending best resources and courses of action to benefit patient needs and return each to optimal quality of life.

  • FMLA
  • STD
  • ADA
Broward College Coconut Creek, FL, Expected in 2024 Bachelor of Arts : Business Administration - GPA :
Work History
The Escape Game - Sr. Disability Case Manager
New Orleans, LA, 07/2019 - Current
  • Manage 130 high case load of complex disability and leave claims.
  • Provide mentoring in technical skills to less-experienced Disability Benefit Specialists and Leave Specialists.
  • Achieved overall audit score of 100% over past 3 quarters, exceeding 95% department goal.
  • Rehabilitation Consultants and Medical Coordinators to facilitate return to work focused plans.
  • Manage and develop excellent relations with Employees, Employers, External HR, doctors, internal.
  • Submission of claims to clinical review for denial due to non-supporting medical documents.
  • Adjudicated and managed complex short-term, appeals and seamless disability claims from initial claim to return to work within strict service level agreements.
Zurich North America Disability Insurance - Workforce Managament
City, STATE, 02/2017 - 07/2019
  • Optimized personnel coverage, preparing work schedules based on staff availability and forecasted demands.
  • Develop and document standards, policies, processes, and business rules around workforce management for multi-site environment
  • Identify and develop future leadership in Workforce management
  • Interact with various department Cast and Leaders to develop process improvements for this operation
  • Workforce management on call volume, forecasting, resource capacity and efficient staff scheduling to meet service level targets
  • Monitor individual and team performance and ensure KPIs are met to achieve customer satisfaction, operational efficiency and team work
  • Assist with developing and maintaining system and process documentation
Matrix Absence Management Inc. - Claims Examiner II AMS
City, STATE, 05/2015 - 02/2017
  • Determines eligibility under federal and state requirements for leaves submitted and determines eligibility under client's plan/policy.
  • Responds to customer service issues within required time frames.
  • Pro-actively communicates decisions within Best Practice guidelines, consistently meeting Performance Guarantee requirements.
  • Makes claim determinations to approve, deny or delay and or reach out to additional resources for review, based on medical certification review and management.
  • Determines duration associated with leave and or disability based on information given by healthcare provider.
  • Communicates approvals, denials, leave extensions, return to work plans and other important information regarding leave to employee and client.
  • Manages STD and leaves of up to 120 - 145 that run are concurrent with Short Term Disability.
  • Developed and implemented performance improvement strategies and plans to promote continuous improvement
Arriva Medical LLC - Team Leader
City, STATE, 12/2011 - 05/2015
  • Resolved team support issues with efficient approach to keep call center operating smoothly and customers satisfied with services.
  • Communicated policy updates and information to team to enhance goal efficiency.
  • Coached team members on metrics and consumer experience behavior identification to improve satisfaction ratings.
  • Defined and documented office procedures, using updated SOPs to provide thorough and comprehensive training for all administrative support staff.
  • Guided employees through routine and complex administrative situations with decisive but motivational approach.
  • Interfaced with cross-functional support groups to manage daily operations.
  • Evaluated employee job performance and motivated staff to improve productivity.
  • Facilitated individual coaching sessions with CSRs to realign productivity goals.
  • Led team of 43 members while providing exceptional customer service
  • Verified confidential budget reports remained up-to-date for Sr. Management
  • Developed and implemented performance improvement strategies and plans to promote continuous improvement

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Resume Overview

School Attended

  • Broward College

Job Titles Held:

  • Sr. Disability Case Manager
  • Workforce Managament
  • Claims Examiner II AMS
  • Team Leader


  • Bachelor of Arts

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