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Life Insurance Medical

Fort Lauderdale, FL
October 09, 2019

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**** ****** ****** ***** ****# 805 Home: 954-***-****

Sunrise, FL 33322

Professional Summary

Responsible Human Resource Professional with excellent communication skills demonstrated by over 20 years of experience in health care industry.

Skill Highlights

Knowledge of HMO’s, PPO and 401K Good written communication OB-GYN, Pediatrics and Adult care experience Team player with positive attitude Maintains strict confidentiality Strong work ethic ICD-10 coding Patient-focused care

CPR Certified Family Medical Leave Knowledge

Long Term and Short Term Knowledge Certified Public Notary Professional Experience

Disability Benefits Specialist 05/2016 Current

Broadspire Sunrise, FL

Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses. Strictly followed all federal and state guidelines for release of information. Wrote clear and detailed clinical notes for clinicians to view. Reviewed, investigated and corrected errors and inconsistencies in financial entries, documents and reports also worked with a third-party vendor on reporting with holdings and offsets Prepared and maintained support documentation.

Processed Long Term Disability Claims

Care Management Associate 11/2006 05/2016

Aetna Life Insurance Company Plantation, Florida

Processed disability claims on a daily basis, contact employees. and Managers when necessary, make determinations on medical claims.

Evaluated patient care procedural changes for effectiveness. Answered clients questions regarding family medical and short term disability. Review Medical Certifications, Patient Flow charts and, attending Physician statements to make decisions on medical leave of absence.

Actively maintained up-to-date knowledge of applicable state and laws and regulations. Handle escalations for Supervisor Contacted Patients throughout their leave of absence to ensure they will return to work effectively.

Communicated with providers on a daily basis to ensure all forms are completed and submitted in a timely matter.

Monitored shared email in-boxes and ensured inquiries were addressed. Coordinated all department functions for team of 30 employees Created pivot tables and spreadsheets to improve inventory management and reporting accuracy. Human Resources Assistant 05/2003 11/2006

United Health Group Sunrise, FL

Assisted with recruiting and boarding tasks such as reference checks, and scheduling interviews Managed information related to leave of absence, unemployment, 401k and other changes Demonstrated and maintained field compliance with federal, state and local employment laws regulations and posters

First Point of Contact for internal employees and external employees to answer or direct inquiries as needed

Contact applicants for interviews both in person and and over the phone Provide administrative assistance to members of the HR department Acquired Expert Knowledge of FMLA policies and Procedures Education and Training

Bachelor of Science: University of Phoenix Human Resource Management 2020 Phoenix, AZ

Associate of Arts: Keiser University - Health Administration 1999 Fort Lauderdale, FL,

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