Aesha Treadwell
Summary
Dynamic Absence Management Claim Specialist at Metlife with expertise in claims evaluation and compliance verification. Proven track record of enhancing customer relationships and achieving a 20% increase in productivity through effective documentation management and team coaching. Adept at navigating complex claims while ensuring adherence to insurance policies and regulations.
Overview
10
10
years of professional experience
Work History
Absence Management Claim Specialist
Metlife
12.2025 - Current
- Evaluates claims for accuracy and completeness in insurance policies.
- Collaborates with clients to gather necessary documentation for claim processing.
- Communicates effectively with stakeholders regarding claim status and updates.
- Reviews policy terms to determine coverage eligibility for claims submissions.
- Maintains detailed records of all claim activities including notes about conversations with claimants or representatives.
- Provides customer service by responding promptly to inquiries from claimants regarding their benefits or coverage.
- Maintains knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Reviews and analyzes insurance claims to determine validity, completeness, accuracy, and eligibility for payment.
- Communicates with other departments to establish action plans and manage open claims to closure.
- Conducts interviews with involved claims parties and witnesses to gather detailed information and arrange investigations.
ADA Accommodation Consultant
Amazon
08.2024 - 12.2025
- Serves as a point of contact for assigned employees providing holistic case management services, including reviewing medical documentation to adjudicate leaves in compliance with the corresponding leave plans, federal and state laws and benefit plans as defined by Amazon.
- Leverages duration guidelines, best practice tools and Amazon resources to support oversight of leave events.
- Troubleshoots issues and ensures technical barriers are removed before, during, or after a leave event.
- Responds to employee issues that may arise during the leave event and ensures a smooth return-to-work plan.
- Ensures successful and accurate claim processing and productivity to involve complex claims efficiently.
- Educates managers and business partners on employee concerns and accommodation needs.
- Communicates regular updates to employees and stakeholders both verbally and in writing.
- Ensures compliance with standard work, federal/state regulations, and company policy.
- Maintains system records to ensure accurate and timely information/documentation.
- Consults with third party administrators, HR, Benefits team, and other departments throughout daily administration.
- Performs other duties as commissioned.
ADA Accommodation Coordinator
Sedgwick
12.2020 - 05.2024
- Conducted initial phone interviews and eligibility determination for employees seeking ADA, FMLA, or STD leave of absence.
- Negotiated accommodation options for employees who sustained a physical or mental impairment and provided referrals for additional resources.
- Conducted peer-to-peer training and improvement strategies with new hires.
- Assisted colleagues with complex claim issues while maintaining daily workload, Client Service Level Agreements and 100% quality scores.
- Performed inbound/outbound calls with physicians, nurses, and medical offices to verify employees’ health information, prior authorizations, and incomplete medical information.
- Maintained client relationships and trust through open communication and top tier claim resolution.
Medicaid Transaction Processing Coach
Indiana Family and Social Services Administration
11.2019 - 11.2020
- Led virtual and in person training for new and existing employees receiving government funded SNAP and Healthcare benefits.
- Identified errors and FAQs amongst teams by conducting weekly meetings to resolve quality errors.
- Resolved complex claims in compliance with federal and state regulations.
- Collaborated with trainers and managers to assist new hires with federal and state policy updates and refreshers on new system features and changes.
Pharmacy Medical Claims Supervisor
Express Scripts, An Accredo Company
12.2016 - 10.2019
- Managed 20+ employees (direct hires and temporary staff).
- Reduced over 1% of production costs and improved overall efficiency for mail order prescriptions.
- Collaborated with 50+ professionals to achieve patient and client satisfaction.
- Reviewed Standard Operating Procedures with coordinators to ensure policies and procedures were understood and compliant by all users.
- Developed various initiatives such as employee engagement initiatives, pitch-ins, and weekly recognitions for exceptional performers.
- Performed coaching’s and one-on-one reviews which increased productivity by 20% and decreased quality errors by 5%, quarterly.
- Worked alongside Human Resources to discuss employee performance, hiring initiates, promotions and demotions.
- Traveled nationally to meet out-of-state staff and collaborated with partners and colleagues, frequently.
Education
Associate of Science - Business
Indiana Wesleyan University
3777 Priority Way S Dr, Indianapolis, IN 4624008-2018
Skills
- Claims evaluation
- Insurance policy analysis
- Compliance verification
- Documentation management
- Claims processing
- Customer relationship management
Values
- Integrity
- Accountability
- Collaboration
- Creativity
- Compassion
- Strategy
- Resolution
Timeline
Absence Management Claim Specialist
Metlife
12.2025 - Current
ADA Accommodation Consultant
Amazon
08.2024 - 12.2025
ADA Accommodation Coordinator
Sedgwick
12.2020 - 05.2024
Medicaid Transaction Processing Coach
Indiana Family and Social Services Administration
11.2019 - 11.2020
Pharmacy Medical Claims Supervisor
Express Scripts, An Accredo Company
12.2016 - 10.2019
Associate of Science - Business
Indiana Wesleyan University