Shiquana Davis
Coral Springs,FL
Summary
Experienced professional with over 10 years of expertise in healthcare, medical records, and claims processing. Skilled in gathering and analyzing data and reports to facilitate the completion of required reporting that summarizes activities and trends. Contributes to the development and implementation of strategic and tactical operational plans to achieve company and departmental goals. Known for developing effective solutions and taking necessary actions to overcome challenges, ultimately driving increased customer satisfaction. A disciplined team player and strong individual contributor who consistently displays dependability, drive, and a strong desire to advance the goals and objectives of the organization.
Overview
9
9
years of professional experience
Work History
Leave Specialist
Aflac
02.2019 - Current
- Administer leave of absence documentation in compliance with standards and regulations.
- Oversee the implementation of FMLA regulations.
- Managed payments for Paid Family Leave State benefits.
- Evaluated FMLA documentation for accuracy and thoroughness.
- Evaluated and recommended approval or denial of FMLA requests in accordance with Federal regulations.
- Coordinates correspondence, forms, and other documents via the claim system
- Keeps complete records of all LOA requests and maintains tracking and analysis of data
Leave of Absence Case Manager
Crawford & Company
01.2017 - 02.2019
- Determines eligibility within the law utilizing consistency and objectivity
- Developed reports for team compliance checks.
- Evaluates and implements State disability regulations in FMLA/LOA administration.
- Maintains regular communication with providers and specialists to ensure accurate medical data.
- Handling a caseload of up to 1,000
- Coordinates administration of FMLA/LOA with STD/WC management.
- Oversees operations of Leave Management Team.
- Led onboarding sessions for incoming Leave Case Managers.
- Assisting with special projects and Takeover claims
Medical Records Clerk
Armor Correctional Services
06.2016 - 12.2017
- Determines eligibility within the law utilizing consistency and objectivity
- Conduct investigations and reviews of member Complaints, Grievances, and Appeals involving the provision of service and benefit coverage issues and claims
- Responded effectively to requests for medical records from legal representatives, insurance companies, and other authorized parties in a timely manner.
- Generates written correspondence to customers such as members, providers, regulatory agencies, and contracted health plans while maintaining the grievances and appeals logs, spreadsheets, and files
- Reviewed charts and flagged incomplete or inaccurate information.
Phlebotomist
Quest Diagnostics
10.2015 - 05.2016
- Obtains blood specimens by performing venipunctures and finger sticks
- Identifies patient identification and explains sampling procedures to patients
- Ensured preservation of specimen quality through adherence to isolation and department protocols.
- Gathered biological specimens for laboratory analysis.
Education
Phlebotomy - Health Sciences
Center For Career Training
Oakland Park, Florida06.2015
High School Diploma - General Student
Boyd H. Anderson High School
Lauderdale Lakes, FL06.2004
Skills
- Appeals and Claim processing
- Team Collaboration, and Leadership
- Customer Service Skills
- FMLA Administration
- Remote Work Experience
- Microsoft application
- Technology proficient
- Conflict Resolution
- Analytical Reporting Skills
- Leave administration expertise
Timeline
Leave Specialist
Aflac
02.2019 - Current
Leave of Absence Case Manager
Crawford & Company
01.2017 - 02.2019
Medical Records Clerk
Armor Correctional Services
06.2016 - 12.2017
Phlebotomist
Quest Diagnostics
10.2015 - 05.2016
Phlebotomy - Health Sciences
Center For Career Training
High School Diploma - General Student
Boyd H. Anderson High School
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