- Avid Reader
- Horror Enthusiast
- Computer Builder
- Baking
- Music
Bi’unca Redmon
Memphis
Summary
Experienced with managing appeals and dispute resolution processes effectively. Utilizes analytical skills to assess and resolve complex cases while ensuring compliance with regulatory standards. Track record of collaborating with teams to deliver timely and accurate outcomes, adapting to changing needs and requirements.
Overview
7
7
years of professional experience
Work History
Appeals Specialist
Sedgwick
12.2025 - Current
- Facilitated resolution of complex appeals, ensuring compliance with regulatory standards and company policies.
- Maintained high levels of accuracy in all written correspondence, ensuring clear communication with relevant stakeholders during the appeals process.
- Analyzed case files to identify discrepancies, enhancing accuracy in decision-making processes.
- Collaborated with cross-functional teams to streamline appeal workflows and improve turnaround times.
- Ensured integrity of the claim appeal process and ensures compliance with ERISA legislation.
Senior Disability Examiner
Sedgwick
12.2023 - 12.2025
- Evaluate and adjudicate disability claims based on client-specific benefit plans.
- Analyze medical documentation including diagnostics and clinical notes to determine benefit eligibility.
- Communicate effectively with claimants and providers to establish expectations for return to work.
- Ensure timely and accurate claims processing, including compliance with worker's compensation and SSDI.
Leave of Absence Coordinator
Sedgwick
10.2020 - 12.2023
- Reviewed and approved FMLA requests in accordance with federal and state laws.
- Maintained consistent communication with employees and ensured compliance with service standards.
- Managed ongoing claims using proprietary systems and documented case progress.
- Service Center Representative
- Provided responsive, empathetic customer service by educating callers on benefit eligibility and claim statuses.
- Demonstrated proficiency in medical terminology and detailed case documentation.
Assistant Manager
SkyKing Fireworks
05.2019 - 07.2020
- Opened and closed store independently, handling daily cash reconciliation and deposits.
- Delivered high-level customer service by informing customers of promotions and product benefits.
- Maintained visual merchandising standards and ensured a clean, organized retail environment.
Education
Bachelor of Arts - Anthropology
University of Notre Dame
Notre Dame, IN05-2020
Master of Arts - Psychology
University of Arizona Global Campus
Arizona05-2027
Skills
- Claims Analysis & Case Management
- Medical Terminology & Documentation
- Customer Relations & Communication
- Time Management & Prioritization
- Microsoft Office Suite
- Workday
- Adaptability
- Problem Solving
- Attention to Detail
- Professionalism and ethics
- Continuous learning mindset
- Strong analytical skills
- HIPAA compliance
- Data entry proficiency
Interests
Timeline
Appeals Specialist
Sedgwick
12.2025 - Current
Senior Disability Examiner
Sedgwick
12.2023 - 12.2025
Leave of Absence Coordinator
Sedgwick
10.2020 - 12.2023
Assistant Manager
SkyKing Fireworks
05.2019 - 07.2020
Bachelor of Arts - Anthropology
University of Notre Dame
Master of Arts - Psychology
University of Arizona Global Campus
Leadership & Involvement
- Co-President, Black Cultural Arts Council – University of Notre Dame
- Spearheaded event planning and logistics for major campus initiatives including annual fashion shows and cultural showcases.
- Fostered community engagement and promoted cultural awareness through student-led events.