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Skills

  • Data analysis and reporting
  • Dispute resolution and negotiation
  • Fair Isaac Claims Advisor
  • FMLA federal regulation compliance
  • Risk management
  • Cross-departmental collaboration
  • Magnify Predictive Targeting System
  • Employee relations during FMLA claims
  • Personal, casualty and property loss
  • Client satisfaction improvement initiatives

Work Experiences

  • Developed positive working relationships with government officials and police officers.
  • Achieved 82% client satisfaction.
  • Ensured that all filed hazard and special hazard claims were properly managed.
  • Was in charge of directing and coordinating the field investigation team's investigations.
  • Built strong relationships with employees and managers.
  • Was in charge of maintaining claims data in initiative systems.
  • Testified on behalf of agency as part of criminal and civic proceedings.
  • Organized framework data in order to finish process files.
  • Verified the accuracy of framework records to maintain the accuracy of the records database.
  • Adhered to mandated regulatory deadlines.

Summaries

  • Strong understanding of claimant intake processes, record documentation, and fraud investigation protocols.
  • Achieved reduced employee absenteeism by 43%.
  • Solid skills in formulating goals and strategies for resolving system claims.
  • FMLA Claims Specialist with a passion for personal, property, and casualty losses and damages.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Criminal investigation, insurance fraud, and surveillance are all part of his background.
  • Reliable and trustworthy.
  • Collaborative professional with experience as the primary point of contact for FMLA-related queries. Improved employee-manager relations and increased process transparency by 71% over the past year.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Detailed Adjuster with 14 years of corporate insurance claims experience.

Accomplishments

  • Collaborated with insurance providers and legal teams to manage FMLA and workers’ compensation cases, reducing overlap issues by 62%.
  • Investigated complex overlapping FMLA and ADA cases, achieving a 83% success rate in legal compliance and employee satisfaction.
  • Provided comprehensive FMLA consultations to 12 employees, increasing FMLA knowledge base and reducing claim disputes by 81%.
  • Reviewed and processed over 9 medical certifications and recertifications, reducing claim processing times by 20%.
  • Served as subject matter expert on FMLA policy updates, advising senior management on regulatory changes that led to a 74% reduction in compliance errors.
  • Reviewed and fine-tuned FMLA cases involving sensitive medical details in compliance with HIPAA, improving confidentiality measures by 45%.
  • Resolved product issue through consumer testing.
  • Collaborated with team of 16 in the development of procedure.
  • Reduced claim processing times for FMLA leaves with real-time status updates, leading to a 76% improvement in employee engagement and satisfaction.
  • Trained incoming FMLA claims team members on compliance regulations and procedural protocols, enhancing accuracy rates by 59%.

Affiliations

  • National Association of Health Underwriters (NAHU)
  • National Employment Law Institute (NELI)
  • Human Resources Certification Institute (HRCI)
  • The Health Advocate Group
  • Institute for Human Resources Information Management (IHRIM)
  • Council for Disability Awareness (CDA)
  • Freemason
  • International Foundation of Employee Benefit Plans (IFEBP)
  • International Association of Administrative Professionals
  • Society for Industrial and Organizational Psychology (SIOP)

Certifications

  • Microsoft Certified Systems Engineer (MCSE)
  • Certified Public Accountant (CPA)
  • Certified Fraud Examiner (CFE) by Association of Certified Fraud Examiners (ACFE)
  • ServSafe
  • CompTIA A+ Technician
  • Salesforce
  • Employee Leave Programs and Policies Certificate by Vantage
  • Certified Administrative Law Specialist (CALS) by framework
  • Legal Aspects of Human Resources Certification by system
  • Certified Leave Management Specialist (CLMS) by Disability Management Employer Coalition (DMEC)

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