Sophia Shaw
DESTACO
Livonia,USA
1
Certification
19
years of professional experience
Dedicated and highly competent Human Resources Professional specializing in Benefits and Integrated Disability Management (IDM), comprehensive benefits administration, and complex leave management. Proven expertise in navigating FMLA, ADA, ADAAA, and return to work coordination while maintaining strict compliance with federal regulations. A natural problem-solver and empathetic communicator who excels at building relationships with employees, department leaders, and insurance carriers to deliver fair, compliant, and supportive case management.
Work History
HR SENIOR SPECIALIST
2 Years 2 Months- Served as the primary HR subject matter expert for benefits and leave administration, consulting with leadership on compliance and regulatory standards.
- Manage full-cycle integrated Disability Management, coordinating FMLA, ADA accommodations, and return -to-work strategies for employees with work restrictions.
- Created and implemented comprehensive FMLA and benefit policies, ensuring alignment with current ADAAA, ERISA, and HIPAA regulations.
- Designed and delivered an interactive FMLA training program for the HR team.
- Lead Open Enrollment activities and manage complex data collection, EDI transmissions, and monthly billing audits across multiple benefit platforms.
- Identified areas in need of critical improvement and implemented new processes.
- Work closely with Finance to streamline invoicing and forecasting for benefits.
HR SENIOR SPECIALIST
7 Years 8 Months- Directed comprehensive benefits and leave administration for the organization, acting as the singular point of contact for high-level FMLA, disability, and workers' compensation case management.
- Established and facilitated clear communication between employees, business units, and insurance carriers to monitor work restrictions and coordinate seamless return to work transitions.
- Provided trusted counsel to HR Business Partners regarding policy interpretation, discrimination laws, and fair employee relations practices.
- Collaborated effectively with three separate unions on retention issues, attendance, and contract language.
- Created FMLA training program for Managers and HR BP as well as implementation of the training.
- Drove organizational change by advising and educating staff-from from-line workers to executives-on benefit programs, Medicare timelines, and total rewards.
- Lead full-cycle Open Enrollment activities, including planning, promoting, implementing, and managing data collection
- Oversaw work of junior personnel, helping to motivate strong performance and improve overall knowledge with focus on mentoring and coaching
ACCOUNT MANAGER
4 Months- Advised and managed 20 employer group accounts, overseeing benefits and open enrollment for 400+ employees.
- Managed compliance risk regarding ACA regulations and guided clients through complex eligibility and coverage scenarios.
- Resolved service, billing, and claim issues.
- Delivered client presentations that effectively articulated products and benefit offerings
ACCOUNT MANAGER
5 Years 10 Months- Served as the primary liaison between carriers, clients, and employees for over 50 employer groups.
- Maintained group compliance with Health Care Reform and resolved intricate billing, claim, and coverage issues with tact and confidentiality.
- Partnered with carrier consultants on RFP renewals and financial negotiations
- Initiated enrollment of individuals and groups, processed renewals, and conducted enrollment audits
AGENT RELATIONSHIP MANAGER
1 Year- Partnered with the VP of Sales on special BCBSM (Blue Cross Blue Shield of Michigan) projects, leveraging a deep understanding of healthcare benefits.
- Performed data analysis, handled underwriting processes, and delivered educational presentations on healthcare products.
- Delivered persuasive and educational presentations to agencies onsite while promoting key products and services
- Primary contact for corporate spin-off company 'Plus'; spearheaded business development with local agents
- Maintained CRM and Agent Web Access, and tracked sales metrics
ACCOUNT MANAGER
11 Months- Delivered excellent client relations in quoting lines of coverage for individuals and groups
- Managed large number of account files, caring for existing coverage needs and processing claims and renewals
- Handled underwriting and enrollment process for clients
- Created open enrollment materials for groups
- Applied proactive, solution-oriented approach to billing, claims, complains, or client issues
Education
BACHELOR OF SCIENCE - Business Management, HR
Skills
Leave Administration: Integrated Disability Management (IDM)
FMLA
ADA
ADAAA
Workers' Compensation
Return -to-Work Programs
Case Management Assessments.
HR Compliance & Law: HIPAA
ERISA
USERRA
ACA
Regulatory Standards
Policy Development
Internal Investigations
Labor Relations.
Benefits & Operations: Compensation design and analysis
Full-Cycle Open Enrollment
Vendor Management
Auditing
Medicare Coordination
Wellness Program Creation.
Technical & Soft Skills: ADP Workforce Now
Oracle
Paycor
Employee Navigator
Microsoft Office Suite (Word
Excel
PowerPoint
Outlook) Public Speaking
Coaching & Advising.
Certification
- State of Michigan Health and Life License, Lansing, MI
- SHRM/CP Certification, in process
Personal Information
Title: Human Resource Senior Specialist
linkedin.com/in/sophia-kae-shaw-284b0242
Timeline
HR SENIOR SPECIALIST
DESTACO
08.2024 - CurrentRead More
HR SENIOR SPECIALIST
COMAU, LLC
07.2016 - 03.2024Read More
ACCOUNT MANAGER
AUSTIN BENEFITS GROUP
01.2016 - 05.2016Read More
ACCOUNT MANAGER
BROOKS FINANCIAL
03.2010 - 01.2016Read More
AGENT RELATIONSHIP MANAGER
ACTION BENEFITS
01.2009 - 01.2010Read More
ACCOUNT MANAGER
ANN ARBOR FINANCIAL
01.2008 - 12.2008Read More
University of Phoenix
BACHELOR OF SCIENCE from Business Management, HR
Read More