Human Resources Project Manager
Resume:
Phone: 619-***-**** Email: adyqqh@r.postjobfree.com
Address: **** **** ******** ***, ********, AZ 85353
Versatile, meticulous, and highly qualified Employee Benefits Specialist/Administrator with extensive experience in FMLA disability leave management, HRIS implementation, project analysis, compensation management, client collaboration experience in the Human Resources field. Adept at collaborating with staff to determine strategy, recommending solutions to improve processes, and implementing system enhancements to streamline operations. Currently seeking a Benefits Administration position, bringing 11+ years of related experience and areas of expertise as follows:
AREAS OF EXPERTISE
Leave of Absence Program Management
Benefits Administration
Strategic Project Planning
System Configuration
Claims Processing/Adjusting
HRIS Implementation
FMLA Claim Examination
HR Support/Analysis
Benefit Plan Enrollment
Upgrades/Enhancements
Medical Billing/Coding
Data Conversion/Analysis
Claim/Payment Reconciliation
Audit/Quality Control
Client Collaboration
Regulatory Compliance
Facilitating the development and implementation of Leave of Absence program and change initiatives to ensure alignment with corporate business models and organizational objectives.
Performing HRIS system conversions, upgrades, and implementations along with other HR-related support activities including benefits/compensation administration and employee benefit plan enrollment.
Planning short- and long-term strategies to support organizational objectives, as well as managing system enhancements and client training programs.
Implementing and testing new system upgrades and software that interface with HRIS while managing relationships with vendors to ensure high levels of service at appropriate costs.
Identifying and troubleshooting issues that affect system performance and provide feedback to appropriate levels of management to find solutions to improve functionality.
Prudential Integrated Claims Examiner, Disability Insurance Oct. 2022-Apr. 2023
Handled a claim block of Disability claims, Absence and/or Paid Leave claims.
Demonstrated ability to deliver accurate, dependable, and trustworthy service to our customers.
A strong customer focus evidenced through maintaining customer relationships.
Strong analytical reasoning
Strong communication skills both written and verbal.
Ability to work to work independently in a fast-paced, metrics driven environment.
Iconma/Bank of America · Project Manager, Human Resources Dec. 2020 – Sept. 2022
Delivering COVID-19 event support to managers and employees of client through a variety of channels which may included telephone and email.
Used sound judgment to mitigated risk and evaluated information received to form fact-based decisions, solved problems, and made formal recommendations in a time sensitive environment.
Provided superb customer care; convey empathy, patience and listening skills.
Exemplified the client Core Values in every interaction with team, clients, and stakeholders.
GreyStar Real Estate/Alliance Residential · Benefit Specialist/HR Coordinator July 2017 – October 2020
Interprets and manages leave programs/policies in accordance with federal and state employment laws while managing all administrative aspects of leave.
Independently approves and/or denies leave cases, document claim updates in the claim database ensuring accuracy, and maintain departmental and policyholder expectations.
Conducts departmental training to remain current with all claim management practices.
Protects personal health information while consistently maintaining a high level of confidentiality and abide by HIPAA rules and regulations.
Documents claim updates in the claim database ensuring accuracy.
Oversees new hire eligibility, status change eligibility, and training notification processes.
Administers company benefit programs such as medical, dental, vision, COBRA, short-term disability, long-term disability, life/accidental death & dismemberment, flexible spending accounts, wellness program and 401(k), etc.
Updates, compiles, audits, and processes reports deemed necessary by Benefits Manager.
Complied with the rules and regulations set forth by Federal, Local, and State government, Alliance policies and procedures.
Leave of absence administration, including disseminating information to associates, and their leadership. Administration of, CFRA and PDL notifications, tracking and status changes needed to fully manage leave of absences full cycle. Responsible for project and time management for all aspects of individual audits including execution and documentation.
Contributed to the improvement of departmental procedural workflow processes of using continuous improvement methodologies, which include eligibility and enrollment processes, vendor performance monitoring.
Manpower/CIOX Health · QA Analyst Aug. 2016 – July 2017
Oversaw project and time management for all aspects of individual audits including execution and documentation.
Matrix Absence Management · FMLA Integrated Claim Examiner Oct. 2016 – May 2017
Interpreted and managed leave programs/policies in accordance with federal and state employment laws.
Managed all administrative aspects of leave include tracking hours used/taken and working closely with HR representatives.
Independently approved and/or denied leave cases, documented claim updates in the claim database to ensure accuracy and maintained departmental and policyholder expectations.
Proactively engaged in departmental training to remain current with all claim management practices.
Protected personal health information while consistently maintaining a high level of confidentiality and abide by HIPAA rules and regulations.
Documents claim updates in the claim database ensuring accuracy.
Care1st Health Plan Arizona · Fee Schedule Analyst Aug. 2015 – Sept. 2016
Implemented and maintained all fee schedule updates in MHC system.
Conducted thorough follow-up and effective resolution and communication in response to other departments.
Collaborated with other departments to understand and implement the goals of each organization.
Xerox TBO · Project Analyst Sept. 2013 – Jul. 2015
Synthesized with the Human Resources department to developed processes related to compensation and benefits.
Provided avenues for ensuring quality of employee benefits management.
Administered and ensured timely enrollment of employee benefits plan and liaison and tracked with vendors for accurate coverage.
Managed online benefit system and troubleshoot errors to ensure data integrity.
Processed and review monthly insurance bills for accuracy and payment advances.
Resolved discrepancies and employee health and welfare complaints and escalations.
Served as a key resource to resolve issues on eligibility, claims and termination.
Responded to associate queries on benefits and insurance claims by troubleshooting problems and interfacing between vendors and employees.
Assisted Implementation Manager and Client Manager with new plan implementation processes.
Worked directly with new business sales to onboard new clients, as well as established carrier/vendor relationships to ensure smooth handling of all client administration.
Cigna Healthcare · Contract Associate Aug. 2011 – Jun. 2013
Reviewed and analyzed implementation materials to created documents for new and existing business, as well as plan documents/contract language for accuracy and compliance.
Analyzed benefits to ensured followed legislation, loaded benefit in the system.
Identified process improvements for own cases directing removal of non-complaint information.
Audited accounts to determine compliance with required state specific health mandated overages such as Autism coverage, well child coverage, postpartum care, and TMJ.
Developed calculations to ensure automated claim payment.
American InterContinental University-Online
Bachelor’s in Organizational Development & Psychology, 2008
American InterContinental University-Online
Associate in Healthcare Administration, 2007
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