Zhikeria Green
Florida
Summary
Dynamic Leave of Absence Coordinator and customer service representative with a proven track record in managing complex workers' compensation and healthcare claims. Expert in CRM software and exceptional communication skills, I excel in building rapport and ensuring client satisfaction. Committed to delivering timely resolutions while maintaining meticulous documentation and a patient, empathetic approach.
Overview
5
5
years of professional experience
Work History
Leave of Absence Coordinator
Sedgwick
04.2023 - 08.2025
- Administer and manage all leave of absence programs including FMLA, ADA, short-ano long-term disability, military, personal, worker compensation and company-sponsored leaves.
- Serve as a primary point of contact for employees and managers regarding leave requests, eligibility, status updates, and return-to-work plans.
- Support the interactive process for reasonable accommodations in collaboration with HR
Business Partners and legal counsel, consistent with ADA and other applicable laws. - Coordinate with third-party administrators (TPAs), insurance carriers, and internal departments such as payroll and benefits to ensure accurate leave processing, pay continuity, and benefit premium tracking.
- Maintain up-to-date records and documentation for all leave cases, ensuring confidentiality and compliance with HIPAA and internal privacy standards.
- Ensure all leaves are administered in compliance with federal and state regulations (e.g., FMLA, ADA, USERRA, PDA), as well as company policies.
Healthcare Customer Service Representative
Results Cx
Remote
08.2021 - 04.2025
- Handles and records inbound pharmacy calls from members, providers, and pharmacies to meet departmental, State regulations, NCQA guidelines, and CMS standards.
- Provides coordination and processing of pharmacy prior authorization requests and/or appeals.
- Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any other necessary information to providers, members, and pharmacies.
- Effectively communicates plan benefit information, including but not limited to, formulary information, copay amounts, pharmacy location services and prior authorization outcomes.
- Assists member and providers with initiating oral and written coverage determinations and appeals.
- Records calls accurately in call tracking system.
Member Service Representative
Chase
Remote
06.2020 - 05.2021
- Provide basic counseling on available products and services to meet member needs
- Assist members with opening and maintaining deposit accounts, loans, and other financial products
- Research and resolve basic account discrepancies and service requests
- Identify opportunities to cross-service products and enhance member relationships through education
- Understand and comply with all relevant federal and institutional regulations related to financial products and services
- Support team members by sharing knowledge and best practices as experience grows
- Ensure cash and other negotiable instruments are handled properly and securely
- Process routine transactions, including deposits, withdrawals, loan payments, and check cashing
Education
Edgewater High
05.2019
Skills
- Demonstrate ability and willingness to learn, strong attention to detail, positive attitude and ability to be flexible and embrace change
- Demonstrate a strong customer focus rooted in empathy
- Communicate effectively with peers, management and customers
- Exercise good judgment and independent decision-making skills
- Demonstrate exceptional listening, questioning, call control, and de-escalation techniques
- Experience with cloud based Call Center ACD/CRM software
- Strong communication, both verbal and written
- Adaptability and flexibility
- Basic proficiency with Internet Explorer, Microsoft Excel and Word, Outlook email, and Adobe Acrobat
- Knowledge of customer service practices and principles
- Excellent data entry and typing skills
- Superior listening, verbal, and written communication skills
- Basic proficiency with Internet Explorer, Microsoft Excel and Word, Outlook email, and Adobe Acrobat
- Excellent data entry and typing skills
- Ability to handle stressful situations appropriately
- Ability to handle sensitive and private information
Timeline
Leave of Absence Coordinator
Sedgwick
04.2023 - 08.2025
Healthcare Customer Service Representative
Results Cx
08.2021 - 04.2025
Member Service Representative
Chase
06.2020 - 05.2021
Edgewater High