Manager, Disability and Leave Management
Resume:
Patsy L. Herzog cell l 978-***-****
*****.******@********.***
Experience
April 2009 - March 2013 - Manage Teams, Disability
Claims/FML & State Leaves (Absence Management)
The Standard Insurance Company
Direct contact with Customers for issue resolution
Interpret Contracts and Summary Plan Documents for
Team
Team members responsible for Disability
determinations and Leave of Absence adjudication
Remain current with Federal and State regulations
Coordinate with Legal Department on legislative
updates
Conduct training to other departments regarding
Disability and Leave of Absence and relevance to
their area
Identify and implement best practices for
Disability and Leave processing and workflows
Develop and present Power Point presentations as
the Disability and Leave of Absence subject matter
expert
Provide Operations response to Requests for
Proposals
Responsible for the Operations introduction of a
new claim processing system for Disability and
Leave of Absence
February 2006 - December 2008 - Manage Teams,
Disability and Absence Management (FML/State/LOA)
Aetna Life Insurance Company
Direct contact with Customers for issue resolution
Interpret Contracts and Summary Plan Documents for
Team
Supervise Disability claim determinations and Leave
adjudication
Participate in ongoing best practice review of
Operations and Services for Disability and Absence
Management
Identify and monitor staffing needs based upon
business requirements
Manage Intake and Claim Processing Teams to meet
performance guarantees, turnaround time and
productivity expectations
Utilization of multiple claim systems and
transitioning customers onto new claim system for
Disability and Absence Management
Network with internal departments to meet customer
needs
Interface with company vendors to ensure compliance
Mentor and coach team leaders for career
development and succession planning
2002 - February 2006 - Team Leader - Claim
Processing
Aetna Life Insurance Company
Responsible for up to 15 employees processing
disability claims and leave adjudication
Customer base was primarily jumbo accounts with
self-funding disability and leave management
Supported account management presentations to
retain customers
Responsible for utilization of multiple claim
systems, including transitioning of claims onto new
claim system
Manage individual and team performance to meet
performance guarantees, turnaround time and
productivity expectations
Develop and implement Performance Improvement Plans
to assist with individual development of
performance expectations
Mentor and coach team members for career
development and succession planning
1996 - 2002 Nurse Case Manager
Aetna Life Insurance Company
Apply Contract and Summary Plan Descriptions to
claims management
Coordinate Return to Work activities with Employee
and Employer
Utilization of proprietary Disability Guidelines
Progressive increase in responsibility for clinical
management of Short Term and Long Term disability
claims.
Sustain ongoing caseload of claim processing.
Utilization of multiple claim systems.
Responsible for coordinating team's daily
assignments and provide back-up for Team Leader.
Assist with adjudication of FML absences.
1979 - 1996 Registered Nurse
Carondelet Psychiatric Care Center Richland, WA
1981 - 1996 Registered Nurse case manager for
outpatient caseload of up to 300 adult patients
with acute and chronic mental illness. Responsible
for nursing assessment of narcotic addiction to
enter methadone program.
1979 - 1981 Inpatient Registered Nurse responsible
for nursing assessment, unit milieu and medication
administration for adolescent and adult patients
Education Washington State University, Pullman, WA
Bachelor of Science Degree - Nursing (BSN)
Licensing and 2006 - 2013 - Member of Disability Management
Affiliations Employer Coalition (DMEC)
1979 - Present
Registered Nurse license in the state of Washington
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