Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Timeline
Generic

Kailah Webster

Richmond,VA

Summary

High performing analytical, self- motivating individual with demonstrated administrative, quality customer service, leadership capability, with strong interpersonal skills, along with both written and verbal communication skills. Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance.

Overview

10
10
years of professional experience
1
1
Certification

Work History

Absence Manager

New York Life Insurance Company
02.2023 - Current
  • Make claim/customer eligibility determinations and manage on-going claims for an assigned caseload of short-term disability claims, through capturing medical information, applying appropriate contractual provisions, following legal guidelines, and leveraging expert resources
  • Make claim/customer eligibility determinations and manage on-going cases for an assigned caseload of FMLA disability claims, through capturing medical information, applying appropriate contractual provisions, following legal guidelines, and leveraging expert resources
  • Communicate with claimants, employers, and various medical professionals to gather information regarding the application for, payment of, and ongoing management of short-term disability benefits
  • Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.)
  • Ability to handle potentially high levels of call volume from customers and clients
  • Respond to various written and telephone inquiries, including eligibility, approval/denial determinations, status and continuation or closure of benefits
  • Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis
  • Network with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information
  • Pay all covered claims accurately and timely
  • Execute on all customer performance guarantees
  • Adhere to standard timeframes for processing mail, tasks and outliers
  • Understand Cigna Group Operations and Corporate Compliance, Policies and Procedures and best practices
  • Stay abreast of ongoing trainings associated with role and business unit objectives
  • Respond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely manner

STD Claim Manager

New York Life Insurance Company
10.2022 - 02.2023
  • Remote
  • Make claim/customer eligibility determinations and manage on-going claims for an assigned caseload of short-term disability claims, through capturing medical information, applying appropriate contractual provisions, following legal guidelines, and leveraging expert resources
  • Communicate with claimants, employers, and various medical professionals to gather information regarding the application for, payment of, and ongoing management of short-term disability benefits
  • Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.)
  • Ability to handle potentially high levels of call volume from customers and clients
  • Respond to various written and telephone inquiries, including eligibility, approval/denial determinations, status and continuation or closure of benefits
  • Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis
  • Network with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information
  • Pay all covered claims accurately and timely
  • Execute on all customer performance guarantees
  • Adhere to standard timeframes for processing mail, tasks and outliers
  • Understand Cigna Group Operations and Corporate Compliance, Policies and Procedures and best practices
  • Stay abreast of ongoing trainings associated with role and business unit objectives
  • Respond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely manner

LTC Senior Benefit Analyst

Genworth Financial
02.2018 - 09.2022
  • Remote
  • Adjudicate Long Term Care Claims for ongoing eligibility claims
  • Research and analyze data to resolve operational challenges for internal/external customer issues
  • Demonstrate sound business decision using risk management and quality protocol
  • Effectively manage and prioritize a work queue and multiple job responsibilities in a fast-paced environment, frequently within service level deadlines
  • Accountable for recognizing and working within a structured environment with clearly defined SOP’s to ensure consistency of claims practices and resolution
  • Respond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely manner
  • Build rapport with the insured, insured’s family, and outside vendors to make sure the insured is receiving the proper care and benefit to suit their daily need.

Genworth Financial, LTC Claims CSR
12.2016 - 02.2018
  • Assisted with inbound calls from policy holder’s or representatives regarding claim and policy inquiries
  • Researched and analyzed data to resolve operational challenges for internal/external customer issues
  • Reviewed and explained member Evidence of Coverage, Explanation of Benefits, and Claims issues while staying in compliance
  • Worked with little to no supervision/guidance, while meeting departmental expectations and goals in a timely manner via email, telephone, and fax
  • Recognized as an outstanding performer for proficient claim and call handling.

Cashier

Martin’s
03.2016 - 11.2016
  • Assisted in store opening and closing
  • Provided unmatched customer service and complaint resolution specialist
  • Supported daily stock and merchandise functions
  • Operated a balanced cash drawer while handling other form of payment transactions.

Peer Tutor

City of Richmond
06.2013 - 08.2013
  • Mentored elementary students ages 6-7 with math to better comprehend basic equations
  • Used active listening skills to assist with individual reading sessions and learning activities
  • Supported administrators with organizing paperwork and assisted with preparing new assignments for students.

Education

Advanced High School Diploma -

Thomas Jefferson High School
Richmond, VA
6.2015

Skills

  • Team Leadership
  • Customer Relationship Management
  • Project Management
  • Staff Management
  • Time Management
  • Verbal and Written Communication
  • Complex Problem-Solving
  • Productivity Performance
  • Issue and Conflict Resolution
  • Strategic Planning
  • Scheduling and Coordinating
  • Managing Multiple Tasks

Accomplishments

  • AP Literature and Composition Award 2014-2015
  • Yvonne T. Smith Science Achievers Awards 2014-2015
  • AP US Government Award 2014-2015
  • President's Education Awards Program (Outstanding Academic Excellence) 2014-2015
  • Vice President for Future Business Leaders of America

Certification

Anti-Fraud

Lean Awareness

Harassment Prevention

Timeline

Absence Manager

New York Life Insurance Company
02.2023 - Current

STD Claim Manager

New York Life Insurance Company
10.2022 - 02.2023

LTC Senior Benefit Analyst

Genworth Financial
02.2018 - 09.2022

Genworth Financial, LTC Claims CSR
12.2016 - 02.2018

Cashier

Martin’s
03.2016 - 11.2016

Peer Tutor

City of Richmond
06.2013 - 08.2013

Advanced High School Diploma -

Thomas Jefferson High School

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Kailah Webster