Brandon Spencer
Kissimmee,FL
Summary
Detail-oriented and results-driven claims professional with over 6 years of experience in claims adjudication, disability management, and employee benefits. Skilled in analyzing complex claims, interpreting ICD-10 and CPT codes, and ensuring regulatory compliance. Proven expertise in mentoring teams, resolving discrepancies, and delivering exceptional service while maintaining accuracy and efficiency.
Overview
10
10
years of professional experience
Work History
Senior Disability Case Manager
Amazon Corp.
Las Vegas, NV
02.2020 - Current
- Managed a high-volume caseload of disability claims, ensuring compliance with federal and state regulations.
- Streamlined workflows, increasing claims processing efficiency by 30% and reducing errors.
- Provided technical guidance to junior staff, enhancing team knowledge and compliance standards.
- Coordinated with healthcare providers to resolve complex claims and ensure accurate determinations.
- Supervised a team of disability case managers, providing leadership, training, and performance coaching.
- Monitored and adjudicated complex disability claims, ensuring compliance with FMLA, ADA, and corporate policies.
- Conducted quality reviews, identified trends and process gaps, and recommended improvements.
- Acted as a final escalation point for claim disputes, ensuring resolution aligned with policy guidelines.
- Developed and implemented customer service policies and quality control measures to improve claims processing.
Leave of Absence Coordinator
Sedgwick CMS
Orlando, Florida
05.2018 - 03.2020
- Processed and adjudicated employee leave requests, including FMLA and ADA claims, ensuring compliance.
- Performed eligibility verifications and applied cost-containment measures to reduce claims expenses.
- Maintained confidential medical records and coordinated return-to-work schedules.
Leave of Absence Specialist
Reed Group Ltd
Orlando, FL
05.2015 - 05.2018
- Reviewed and processed FMLA, ADA, and workers’ compensation claims, ensuring compliance with legal standards.
- Provided guidance to employees on leave policies, reducing disputes and improving claim understanding.
- Maintained detailed documentation to support claim decisions and escalated complex cases as needed.
Education
University of Central Florida
Orlando, FLSkills
- Claims Management: Case Handling, Risk Assessment, Claims Investigation, Compliance
- Regulatory Knowledge: FMLA, ADA, Short & Long-Term Disability, Federal & State Policies
- Leadership & Team Development: Mentoring, Performance Management, Process Optimization
- Analytical Skills: Claims Analysis, Data Reporting, Process Improvement
- Technical Skills: Microsoft Office Suite, Case Management Systems, Data Analysis Tools
Timeline
Senior Disability Case Manager
Amazon Corp.
02.2020 - Current
Leave of Absence Coordinator
Sedgwick CMS
05.2018 - 03.2020
Leave of Absence Specialist
Reed Group Ltd
05.2015 - 05.2018
University of Central Florida