Summary
Overview
Work History
Education
Skills
References
Languages
Timeline
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Jacqueline Perez

St. Cloud,FL

Summary

Motivated Team Lead possessing excellent leadership and planning abilities. Focused on delivering high-quality products on tight schedules. Monitors, trains, and encourages employees to improve skills and meet demanding targets. History of successfully developing and managing strong teams through proactive training and issue management.

Overview

17
17
years of professional experience

Work History

Workforce Management Team Lead

Sedgwick
Orlando, FL
06.2018 - Current
  • Modifies and directs project plans to meet organizational needs
  • Orchestrates projects within strict timeframes and budget constraints by solving complex problems and working closely with senior leaders
  • Achieves project deadlines by coordinating with operations to manage performance
  • Develops executive presentations and reports to facilitate project evaluation and process improvement
  • Supervises multiple teams of examiners and/or several (minimum seven) technical operations colleagues for a wide span of control; may delegate some duties to others within the unit
  • Identifies and advises management of trends, problems, and issues as well as recommended course of action; informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the office
  • Provides technical/jurisdictional direction to examiner reports on claims adjudication
  • Compiles, reviews and analyzes management reports and takes appropriate action
  • Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards for claims focused on ADA, FMLA and other federal, state and local standards
  • Assists, promotes, and coordinates staff engagement activities, programs, and events
  • Acts as second level of appeal for client and claimant issues regarding claim specific, procedural, or special requests; implements final disposition of the appeal
  • Reviews reserve amounts on high-cost claims and claims over the authority of the individual examiner
  • Operate business and office machines such as copiers, scanners, and other equipment
  • Assures that direct reports are properly licensed in the jurisdictions serviced
  • Ensures claims files are coded correctly and adequate documentation is made by claims examiners.

Service Center Team Lead

06.2016 - 06.2018
  • Supervise team of 15-23 Service center representatives’ along with assisting in overseeing other teams when team lead is absence
  • Assesses and evaluates current team competencies to develop a baseline of service opportunities
  • Leads efforts to refine Service Center measures and tracking systems for program improvements
  • Maintains records of training activities, colleague progress and program effectiveness
  • Analyzes and resolves customer service issues
  • Supervises a Service Center unit (team) providing leadership, direction and support and monitors team's daily performance
  • Monitors workloads and status; supports colleagues by providing advice on handling complex issues; and identifies and resolves problems and issues
  • Works with team leadership to develop, implement and monitor staff development plans with a focus on overall customer service skills
  • Communicates with upper management regarding unit issues and resolutions.

Senior Service Center Representative

09.2015 - 06.2016
  • Handle entering of new Short term disability and Leave of absence requests based on FMLA guidelines for Walmart callers, while following client specific instruction using claims management systems
  • Assesses and evaluates current team competencies to develop a baseline of service opportunities
  • Leads efforts to refine Service Center measures and tracking systems for program improvements
  • Maintains records of training activities, colleague progress and program effectiveness
  • Analyzes and resolves customer service issues
  • Supervises a Service Center unit (team) providing leadership, direction and support and monitors team's daily performance
  • Monitors workloads and status; supports colleagues by providing advice on handling complex issues; and identifies and resolves problems and issues
  • Works with team leadership to develop, implement and monitor staff development plans with a focus on overall customer service skills
  • Communicates with upper management regarding unit issues and resolutions.

Member Service Representative

Catamaran RX
Orlando, FL
06.2014 - 09.2015
  • Handle pharmacy benefit questions for several different major companies, not limited to Southwest Airlines, Target, Whirlpool as an example
  • Provide troubleshooting to Pharmacies, Doctors’ Offices and members alike
  • Enter Mail Order request for members
  • Answer any eligibility, accumulation or deductible questions members may have
  • Provide accurate information as related on Plan Documentation
  • Other job related duties as required.

HR Office Manager

Wyatt VI, Inc
Christiansted, VI
02.2007 - 10.2011
  • Administers various human resource plans and procedures for all company personnel; assists in the development and implementation of employee handbook and personnel policies and procedures, in conjunction with senior management
  • Performs benefits administration to include claims resolution, change reporting, approving invoices for payment and communicating benefit information to employees
  • Conducts recruitment efforts; conducts new-employee orientations; monitors career-pathing program
  • Handles employee relations counseling, outplacement counseling and exit interviewing
  • Maintains company organization charts and the employee directory
  • Recommends new approaches, policies and procedures to effect continual improvements in efficiency of the department and services performed
  • Maintains compliance with federal and state regulations concerning employment
  • Responsible for management of the building, which includes but not limited to managing repairs, tenant issues, etc
  • Supervises the maintenance of office equipment, including copier, fax machine, etc
  • Supervises and coordinates overall administrative and office activities.

Education

MBA - Business Management Specializing in People Management

UAGC
06.2024

Bachelors - Business Management

AIU Online
07.2017

High School Diploma -

St. Croix Central High School
06.2003

Skills

  • Active Listening
  • Critical Thinking
  • Problem Solving with focus in customer service
  • Oral and Written Communication
  • Interpersonal Skills
  • Leadership
  • Time Management
  • Computer Literate
  • Research Expertise
  • Trend tracking
  • Regulatory Compliance
  • Production Monitoring
  • Schedule Management
  • Performance monitoring
  • Talent Acquisition
  • Human Resources Management
  • Employee engagement
  • Diversity and Inclusion
  • Coaching and Mentoring
  • Key Performance Indicators
  • Performance Improvement

References

References Available upon request.

Languages

  • Bilingual (Spanish/English)
  • Timeline

    Workforce Management Team Lead

    Sedgwick
    06.2018 - Current

    Service Center Team Lead

    06.2016 - 06.2018

    Senior Service Center Representative

    09.2015 - 06.2016

    Member Service Representative

    Catamaran RX
    06.2014 - 09.2015

    HR Office Manager

    Wyatt VI, Inc
    02.2007 - 10.2011

    MBA - Business Management Specializing in People Management

    UAGC

    Bachelors - Business Management

    AIU Online

    High School Diploma -

    St. Croix Central High School
    Jacqueline Perez