GERRIAH PIGGEE
Frisco,USA
Summary
Results-driven Absence Management Claim Specialist with over 6 years of experience administering FMLA, ADA, and employer-sponsored leave programs while ensuring compliance with federal and state regulations. Expertise in managing intake calls, conducting eligibility determinations, reviewing medical certifications, tracking intermittent leave, and coordinating return-to-work processes. Strong customer focus and ability to manage high-volume caseloads while maintaining accurate documentation and delivering clear, compliant correspondence in fast-paced environments. Recognized for navigating complex regulations and implementing efficient processes that foster team collaboration to achieve optimal results in dynamic workplace settings.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Absence Management Specialist
New York Life Insurance Group
Texas
03.2020 - 11.2025
- Administered end-to-end FMLA, ADA, and company leave claims in compliance with federal, state, and employer-specific plan requirements.
- Managed intermittent and continuous leave claims, including tracking usage, coordinating recertification's, and confirming return-to-work status.
- Managed 50+ daily employee emails related to leave management, attendance updates, and HR policy inquiries.
- Maintained accurate system updates, claim notes, and diary documentation to reflect current leave status and regulatory compliance.
- Evaluated medical documentation to determine eligibility for various types of leaves, maintaining strict confidentiality standards.
- Ensured consistent application of FMLA, ADA, HIPAA, and ERISA requirements across multi-state employee populations.
- Managed complex cases involving multiple overlapping leave types, ensuring all relevant laws were properly applied and adhered to throughout the duration of each case.
- Collaborated with HR teams to develop and implement absence management strategies, enhancing employee support.
- Managed complex absence claims to ensure compliance with company policies and legal regulations.
Senior Claim Representative
UnitedHealth Group
Irving, TX
01.2017 - 03.2020
- Managed a high-volume caseload of disability and complex claims, meeting strict quality, timeliness, and documentation standards.
- Applied critical thinking and investigative skills to resolve eligibility questions and disputed claims.
- Collaborated with cross-functional teams to resolve high-priority claims issues effectively.
- Analyzed complex claims for accuracy, ensuring compliance with regulatory standards.
- Drafted professional correspondence outlining claim decisions, next steps, and regulatory requirements.
- Served as a subject-matter resource for claim policy interpretation and compliance.
- Improved workflow efficiency by implementing a claims triage process that reduced backlog by 30%.
- Led claims processing initiatives to enhance efficiency and reduce turnaround times.
- Mentored junior representatives, fostering skill development and improving team performance.
Customer Service Representative
ACE Cash Express Inc.
Irving, TX
08.2016 - 01.2017
- Navigated complex customer interactions by resolving sensitive and escalated issues during 50+ daily calls in a high-pressure setting.
- Applied problem-solving abilities and empathetic communication to enhance user experience while managing multiple systems.
- Consistently praised for professionalism and commitment to enhancing customer satisfaction.
- Utilized strong communication and analytical skills to resolve customer inquiries efficiently.
- Facilitated efficient financial transaction support, ensuring swift solutions to improve overall customer satisfaction.
- Facilitated training sessions for new staff on customer service protocols and operational procedures.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Education
Associate of Science - Paralegal Studies
University of Dallas
Irving, TX07-2027
High School Diploma -
DeSoto High School
DeSoto, TX06-2016
Skills
- LOA administration and compliance
- Accurate case note recording
- Regulatory leave oversight
- Familiarity with federal compliance standards
- Dispute resolution strategies
- Human resources policies
- Collaborative project management
- Skilled in HRIS and case management platforms
- Effective stakeholder communication
- Analytical decision-making
- Administration of leave tracking and recertification processes
- Return-to-work process oversight
Accomplishments
- Coordinated absence management processes, resulting in improved workforce coverage and reduced unplanned staffing gaps.Used Microsoft Excel to develop inventory tracking spreadsheets.
- handled 200+ employee leave cases
- Achieved accuracy through effectively managing employee leave requests, tracking absences, and coordinating with HR and payroll systems.
Certification
- Completed internal certification training in leave and absence management
Languages
English – Full Professional Proficiency
Timeline
Absence Management Specialist
New York Life Insurance Group
03.2020 - 11.2025
Senior Claim Representative
UnitedHealth Group
01.2017 - 03.2020
Customer Service Representative
ACE Cash Express Inc.
08.2016 - 01.2017
Associate of Science - Paralegal Studies
University of Dallas
High School Diploma -
DeSoto High School