Bianca Liburd
St. Cloud,FL
Summary
Dedicated Disability Leave Case Manager with extensive experience managing high volumes of claims, ensuring compliance and accuracy in case documentation. Proven ability to collaborate with stakeholders to create tailored return-to-work plans, enhancing employee support and satisfaction.
Overview
11
11
years of professional experience
Work History
Customer Service Representative
Wawa
St. Cloud, Florida
10.2025 - Current
- Delivered high-quality service in fast-paced environments while prioritizing client satisfaction.
- Maintained safety, cleanliness, and operational standards to ensure compliance.
- Demonstrated effective teamwork and communication while managing multiple tasks efficiently.
Disability Leave Case Manager
Amazon LLC
Virtual
06.2020 - 09.2023
- Facilitated and managed all aspects of disability leave cases, including intake, assessment, and coordination of medical documentation, ensuring compliance with legal requirements and company policies.
- Collaborated with employees, healthcare providers, and HR teams to develop individualized return-to-work plans, providing guidance and support throughout the entire disability leave process.
- Conducted thorough investigations and analysis of disability leave requests, utilizing strong problem-solving skills to identify potential risks and implement appropriate accommodations to promote successful transitions back to work.
- Maintained accurate and detailed records, documenting case progress, communications, and outcomes, to ensure a comprehensive and organized approach to disability leave management.
- Managed 180-200 claims daily, reviewing documentation and approving or denying claims based on client and federal policies.
- Approved decision reviews for case managers and served as the point of contact for claim escalations.
- Acted as an interim manager and collaborated with payroll for procedure updates.
- Collaborated with internal teams for the implementation of processes and correspondence.
- Demonstrated expertise in state leaves, including WA/CA/NY/NJ paid benefits.
- Maintained an average call quality of 99%, exceeding the average 95% benchmark.
- Achieved exemplary scores for all metrics, including no escalations, no overdue tasks, and high voice of customer scores.
- Served as a subject matter expert in chats and assisted members in understanding their company's different policies and plans.
Leave Case Manager
Reed Group
Orlando, United States
06.2017 - 06.2020
- Successfully managed a high volume of 150-200 claims daily.
- Reviewed documentation and diligently applied client and federal policies to make accurate approvals and denials.
- Conducted outbound calls to healthcare providers to gather essential details for efficient claim processing.
- Exhibited exceptional Quality Assurance skills in supervising the CSS team.
- Conducted Side by Sides with team members, providing thorough evaluations to enhance call quality.
- Implemented comprehensive development training sessions for newly hired employees.
- Consistently achieved an impressive average call quality of 99%, surpassing the average of 95%.
- Supported the training of New Hires and provided valuable floor support during their transition period.
Senior Member Services Lead
Optum Rx
Orlando, United States
11.2015 - 06.2017
- Provided comprehensive assistance to patients regarding their pharmacy benefits via phone, ensuring exceptional customer service.
- Facilitated understanding of prescription coverage for members, resulting in increased clarity and satisfaction.
- Effectively managed medication orders for home delivery on behalf of patients, streamlining the process for convenience and efficiency.
- Coordinated refill requests with physicians' offices, enhancing patient experience through streamlined healthcare communication.
- Collaborated with pharmacies to successfully submit claims, ensuring accurate and timely processing.
- Served as a subject matter expert for the home delivery system, providing valuable insights and guidance to colleagues.
- Demonstrated exceptional skills as a pilot, testing new systems before implementation to optimize operational efficiency.
- Evaluated agent calls for quality assurance, identifying improvement opportunities to enhance overall service quality.
Education
Bachelor of Science - Nursing
Cambridge Healthcare And Technology
Orlando, Florida08-2027
Skills
- Communication
- Product knowledge
- Problem resolution
- Attention to detail
- Detail orientation
- Effective communication
- Communication
- Empathetic
- Organized
- Adaptable
- Analytical
- Adaptable
Timeline
Customer Service Representative
Wawa
10.2025 - Current
Disability Leave Case Manager
Amazon LLC
06.2020 - 09.2023
Leave Case Manager
Reed Group
06.2017 - 06.2020
Senior Member Services Lead
Optum Rx
11.2015 - 06.2017
Bachelor of Science - Nursing
Cambridge Healthcare And Technology