Shirley Heera
Port Saint Lucie,FL
Summary
Senior Claim Specialist, LTD and STD, 20 years of expertise and experience. Possess extensive experience in training, auditing, system testing, and managing for accuracy STD, LTD, and knowledge of FMLA claims, including payroll functions. Compiling data, identifying error trends, and implementing action plans to improve personal and departmental quality performance. Proven ability to multitask, detail-oriented, adapt easily to new challenges, and demonstrate the ability to work independently and/or in a team, fast-paced environment. Assignments include multiple high-profile national corporations with complex business rules and performance guarantees, collection expertise, and special need account. Recognized by customers and clients for caring service and quality excellence, with consistent loyalty survey scores exceeding standards.
Overview
36
36
years of professional experience
1
1
Certification
Work History
Senior Ability Specialist
The Hartford (acquired from Aetna)
01.2012 - 01.2023
- Responsibilities include gathering information during initial claims to make sound decisions in line with Long-Term Disability (LTD) contracts using critical thinking and expertise, claims queries, payroll processing and plan administration
- New account implementation, working with other departments to ensure a successful transition from other carriers
- Facilitated team huddles discussed performance scorecard, participated in the Job Quest program as a mentee and a mentor, Testing Champion for system.
Senior Disability Benefits Manager (LTD)
Aetna Insurance
01.2004 - 01.2012
- Responsibilities include processing Initial and continuing Long Term Disability (LTD) claims
- Claims queries, payroll processing and plan administration
- New account implementation, creating process flows and imputing letters for BA unit, working with other departments to ensure a successful transition from other carriers.
Administrative Assistant
Kemper Insurance, Platinum Equity (acquired from Kemper) and Broadspire (from Platinum acquired)
01.1998 - 01.2003
- Responsibilities includes scheduling, communication, organization, documentation, supporting field case manage with editing reports
- Referral Liaison for Internal and Special Services
- Kemper Subsidiaries in Ergonomic, Life
- Care Plan providing 24 hours service ensuring special instructions are communicated effectively to the field.
Manager
Once Upon a Kid (manufacturing/retail)
Hallandale, FL, USA
01.1987 - 01.1998
- Supervised employees and monitored their production, hired, and trained personal, handled inventory control, purchasing, shipping, and receiving, handled company's deposits/collections and all reports.
Customer Service Representative
Migene Corporation D/B/A Kidz
North Miami, FL, USA
- Sales.
Education
SER/IBM Business Institute
Pembroke Pines, FLSkills
- Claims Administration
- Claims Investigation & Adjudication
- Benefits Eligibility Assessment
- Medical Terminology
- Regulatory & Contractual Compliance
- Customer Communication
- System Testing Champion
- Emergency Response
- Quality Assurance
- Root Cause Analysis
- Resource Allocation
- Customer Relations
Certification
Earned numerous Hartford DNA Badges.
References
Available upon request
Timeline
Senior Ability Specialist
The Hartford (acquired from Aetna)
01.2012 - 01.2023
Senior Disability Benefits Manager (LTD)
Aetna Insurance
01.2004 - 01.2012
Administrative Assistant
Kemper Insurance, Platinum Equity (acquired from Kemper) and Broadspire (from Platinum acquired)
01.1998 - 01.2003
Manager
Once Upon a Kid (manufacturing/retail)
01.1987 - 01.1998
Customer Service Representative
Migene Corporation D/B/A Kidz
SER/IBM Business Institute
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