Leeanne Kristal Molina

· Replying to inbound customer inquiries and questions through various channels including chat, email, phone and virtual meetings

· Identifying, troubleshooting, and escalating bugs to the development team using standardized escalation paths

· Working closely with sales, product, engineering and marketing teams to aid with various internal initiatives such as beta testing programs, documentation creations, and feedback sessions

· Assisting customers with regards to their accounts including billing and payment method updates.

• Supervised day-to-day operations to meet performance, quality and service expectations.
• Improved customer satisfaction by addressing and resolving complaints promptly.
• Developed strong working relationships with staff, fostering a positive work environment.
• Promoted teamwork within the workplace by encouraging collaboration among staff members on various project tasks.

Short-Term Disability Claim Analyst

• Ensured employees received benefits when temporarily unable to work due to illness or injury.
• Evaluated medical documentation (eg. FMLA and STD form, HCPC, Office Visit Notes Discharge Order) to confirm eligibility for short-term disability benefits.
• Verified policy coverage and ensured claims met company and legal requirements.
• Processed claims efficiently to provide timely benefit decisions.
• Contacted healthcare providers to obtain medical details (CPT codes, ICD-10 diagnoses, dates of service).
• Communicated with claimants and employers to explain benefits, timelines, and claim status.
• Responded to inquiries and guided employees through claim procedures.

Federal Leave Management Claim Analyst

• Administered and oversaw employee leave programs within federal agencies, ensuring compliance with complex laws and regulations.
• Ensured compliance with FMLA, ADA, military leave, and other federal entitlements.
• Tracked accruals, balances, and eligibility for sick leave, annual leave, and special categories.
• Reviewed and processed requests for short-term disability, Worker’s Compensation, and leave without pay.
• Validated medical documentation and eligibility requirements.
• Maintained accurate, audit-ready records for reporting and compliance.
• Served as a point of contact for employees requesting leave, explaining rights, responsibilities, and timelines.
• Coordinated with healthcare providers to obtain medical details (CPT codes, ICD-10 diagnoses, dates of service).
• Advised managers and HR staff on proper handling of leave requests.

• Receive and evaluate Worker’s Compensation claims submitted by employees, employers, or healthcare providers.
• Confirm coverage under Worker’s Compensation policies and ensure claims meet state and federal requirements.
• Review medical records, CPT codes, ICD-10 diagnoses, and provider notes to validate injury details and treatment plans.
• Act as a liaison between employees, employers, healthcare providers, and insurers to clarify claim status, timelines, and benefits.
• Ensure adherence to Worker’s Compensation laws, HIPAA, and company policies.
• Enter and update claim details in systems, ensuring accuracy and timeliness of benefit decisions.

• Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
• Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
• Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
• Responded to customer requests for products, services, and company information.

• Encoded pharmacy benefit details directly into the members’ portal
• Applied correct coding for copay structures including preferred brand, non-preferred brand, and specialty medications.
• Determined patient responsibility for deductibles and coinsurance based on plan design.