Experience

i-TEK SOLUTIONS, LLC
• United States
• Staffing and Recruiting
• 1 - 100 Employee
• HR Operations Analyst (contracted with GoDaddy)

  • Mar 2022 - Present

County of Riverside
• Government Administration
• 700 & Above Employee
• Human Resources Technician (remote)

  • Jan 2020 - Nov 2020


TriWest Healthcare Alliance

• Hospitals and Health Care
• 700 & Above Employee

• Leave Benefits Administrator

  • Jan 2019 - Jul 2019

  Arranges and provides medical services for our Veterans across the U.S. Arranges and provides medical services for our Veterans across the U.S.



Cigna

• United States
• Wellness and Fitness Services
• 700 & Above Employee

• Group Claims Senior Associate- LTD (remote)

  • Apr 2016 - Jan 2019

  Third Party Administrator processing STD/LTD claims for clients across the U.S. Third Party Administrator processing STD/LTD claims for clients across the U.S.



Matrix Absence Management

• United States
• Insurance
• 300 - 400 Employee

• Integrated Claims Examiner (remote)

  • Jun 2013 - Jan 2015

  Investigate, evaluate and determine benefit eligibility of Short Term Disability claims in a timely fashion. Determine eligibility under federal and state requirements for leaves submitted. Medical certification review and management supplied by the healthcare provider. Determine the duration associated with the leave based on the information given by the healthcare provider. Communicate approvals, denials, leave extensions, return to work plans and other important information regarding the claim to the employee and client. Manage leaves that are concurrent with Short Term Disability and Workers’ Compensation. Manage intermittent, continuous and client specific leaves of absences/FMLA. Process all absences within the specific timeframes outlined within Matrix Best Practices guidelines. Show less



Prudential Financial

• United States
• Financial Services
• 700 & Above Employee

• Leave of Absence Manager (remote)

  • Nov 2009 - Jun 2013

  Manage assigned caseload of complex, integrated STD (Short Term Disability), DBL, TDB and Absence leaves: FML, USERRA, state leaves (CT FML, CA PFL, CA PDL, HI PDL, etc) and in-house personal leaves as a third party contractor for companies across the entire United States. Clients cover all 50 states, therefore requiring a knowledge base of any/all specific state leaves. Communicate very closely with physicians and other licensed professionals in regards to claimant’s health condition and medical documentation required for processing of claims. Establish and maintain a good rapport with HR staff as well as the employee on leave. Continue with open lines of communication for possible early return to work, extension of leave and benefits, death or even termination of employment. Offer guidance and recommendations to HR staff regarding any concerns or issues involving an employee’s leave and possible disciplinary actions. Work closely with designated HR staff to ensure employees return to work with any temporary or permanent modified duty or work restrictions. At times, initiate facilitated claims discussion with professional medical personnel on site to evaluate complex or large volumes of medical records received for a particular claim. Workers' Compensation is involved, must coordinate accordingly with designated carrier and/or HR staff for information necessary to render decisions for STD/FML. Analyze, approve or deny claims for contestable and non-contestable cases. Generate all formal correspondence providing notice of disability and leave status. Provide technical assistance to other claims personnel as needed. Monitor and manage claims through its duration and follow plans to closure. Coach new hires and monitor/review all claims that are processed for accuracy. Provide guidance on interpreting med certs, how to function within Prudential’s DCMS system that tracks all leaves, and other standard operating procedures. Show less

• Absence Leave Coordinator

  • Feb 2008 - Nov 2009

  Manage assigned caseload of complex absence leaves: FML, USERRA, state leaves (CT FML, CA PFL, CA PDL, HI PDL, etc) and in-house personal leaves as a third party contractor for companies across the entire United States. Prudential’s clients’ size ranges anywhere from a 1, 000 employees to larger clients with over 50,000 employees. Because Matrix’s clientele covers all 50 states, it is imperative to be very knowledgeable of the varied leave laws from state to state, eligibility requirements and leave entitlement. Tracked leaves for multiple companies. Work efficiently and effectively under strict time constraints to both evaluate and process initial leave eligibility and initial decision of claim. If Workers’ Compensation is involved, must coordinate accordingly with designated carrier and/or HR staff for information necessary to render decision for STD/FML. Knowledgeable of the varied leave laws from state to state to determine eligibility, how they should be applied to a leave (entitlement). Analyze, approve or deny claims for contestable and non-contestable cases. Generate all formal correspondence providing notice of disability and leave status. Provide technical assistance to other claims personnel as needed. Monitor and manage claims through its duration and follow plans to closure. Establish and maintain a good rapport with HR staff as well as the employee on leave. Continue with open lines of communication for possible early return to work, extension of leave, death or even termination of employment. Offer guidance and recommendations to HR staff regarding any concerns or issues involving his/her leave and possible disciplinary actions. Offer guidance and recommendations to HR staff regarding any concerns or issues involving his/her leave and possible disciplinary actions. Capable of handling high volume case load with extreme accuracy and efficiency. Show less

• HR Technician II/ HR Analyst

  • Oct 2004 - Feb 2008

  Handled all aspects of Employee Relations including investigations, generating formally written reports to support level of discipline issued and being present during arbitration hearings to support findings. Worked very closely with Union Reps, Managers, Supervisors and Employees. All levels of recruitment and selection (using Resumix) involving reviewing of resumes, selecting qualified candidates, sitting on interview panels and final candidate selection. Coordinate and participate in all job fairs. Act as Workers’ Compensation Liaison between the manager/supervisor, employee and Workers’ Comp Department with regards to how to complete the paperwork and report the claim, time frame involved for initial decision and status of claim, final decision. Also played lead role of Designee for Riverside County Regional Medical Center Hospital’s Return To Work Program locating temporary assignments for all employees able to return to work with work restrictions or certain limitations for brief period of time. Reached out to various department and their supervisors to arrange for the temporary modified duty assignments. Continued to assist with the monitoring of the temporary work assignment through its duration. Also acted as ADA Coordinator facilitating the interactive process with employees and managers/supervisors to determine best solution for both parties involved regarding employees ability to return to work. Also performed all functions as Absence Leave Coordinator dealing with all FMLA, LOA, PDL and CFRA to set up/manage and monitor the claims until exhaustion or return to work. Various other HR duties as needed. Attend Unemployment Hearings as needed and processed DFEH complaints. Show less