Calli Brophy
Orlando,FL
Summary
Detail oriented professional with extensive experience in benefits management and case management, notably at Sedgwick. Proven track record of achieving exceptional audit scores and creation of several optimization tools that have been implemented by company. Skilled in medical terminology and consistently delivers highly accurate input date with exceptional customer service expectations.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Operational Assistant
Marshall Insurance Group
11.2024 - Current
- Serves as Back-up Operations Manager
- Managed day-to-day department operations with effective workflow coordination.
- Solved problems timely and effectively, ensuring customer satisfaction.
- Provided administrative support with accurate document preparation and data entry.
- Collaborated with other departments to foster smooth operation of daily processes.
- Opened and properly distributed incoming mail to promote quicker response to client inquiries.
Sr Short Term Disability Specialist
SEDGWICK
07.2023 - 09.2024
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Exceptional audit scores.
- Handled escalated disability claims with efficient success.
- Consulted by management to aid other programs for accurate benefit review and interpretation of regulations, financial payment processing, and error correction of complex/high exposure claims, including, but not limited to, FMLA, Accommodations, and Disability.
- Proficient in medical terminology to process claims and confer with medical providers to process urgent updates via email or phone for customer satisfaction.
Short Term Disability Case Manager
Lifeworks
03.2022 - 07.2023
- Manage and process FMLA (and other Federal leaves as applicable) Military leaves, State leaves, company specific and STD claims. With regard to FMLA, will manage all DOL category claims; including re-certifications and the 2nd and 3rd opinion processes
- Coordinate processes with employers and employees including intake and assessment to ensure compliance of benefits and payments facilitation to employees.
- Managed multi-national client accounts including Dallas School district and Dotnet clients.
- Effectively managed a case count of 125+.
- Ensured compliance with industry state and federal regulations.
- Skill in effectively communicating complex technical matters related to disabilities both verbally and in writing.
Short Term Disability Case Manager
THE GUARDIAN GROUP
09.2017 - 05.2021
- Facilitate expertise of the regulatory and legal requirements of processes within the laws and contracts of high-visibility clients.
- Coordinate processes with employers and employees including intake and assessment to ensure compliance of benefits and payments facilitation to employees.
- Managed multi-national client accounts including Target and Amazon.
- Effectively managed a case count of 125+.
- Ensured compliance with industry state and federal regulations.
- Skill in effectively communicating complex technical matters related to disabilities both verbally and in writing.
Short Term Disability Escalation Specialist
SEDGWICK
09.2013 - 09.2017
- Facilitated research, resolution for escalated inquires.
- Executed technical and jurisdictional requirements for accurate claims processing.
- Exceptional audit scores.
- Handled escalated disability claims with efficient success.
- Consulted by management to aid other programs for accurate benefit review and interpretation of regulations, financial payment processing, and error correction of complex/high exposure claims, including, but not limited to, FMLA, Accommodations, and Disability.
- Proficient in medical terminology to process claims and confer with medical providers to process urgent updates via email or phone for customer satisfaction.
Benefits Specialist
AON HEWITT ASSOCIATES
08.2003 - 09.2013
- Resolved complex employee issues by conducting research, analyzing plan provisions and translating provisions to the ongoing processing environment.
- Develops and documents benefit related processes and guidelines. Working knowledge of benefits related laws and regulations.
- Assisted in training for new staff members.
- Project lead on multiple Team projects.
Skills
- Benefits Management
- Case Management
- Operations Management
- Extensive Knowledge of Medical Terminology
- Mentoring and Team building
- Systems Implementation
- Salesforce
- Excellent organizational and time management skills
- Comprehensive communications skills
- Consistency and Accuracy –consistently scored in top 2 percentile of audits
Certification
- Licensed Property & Casualty Insurance; 2:20 license 11/2024 - Present
- Licensed Notary 9/2022 - Present
Timeline
Operational Assistant
Marshall Insurance Group
11.2024 - Current
Sr Short Term Disability Specialist
SEDGWICK
07.2023 - 09.2024
Short Term Disability Case Manager
Lifeworks
03.2022 - 07.2023
Short Term Disability Case Manager
THE GUARDIAN GROUP
09.2017 - 05.2021
Short Term Disability Escalation Specialist
SEDGWICK
09.2013 - 09.2017
Benefits Specialist
AON HEWITT ASSOCIATES
08.2003 - 09.2013
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