Malisha Stanley
@malishastanley
Claims specialist with 11+ years managing PFML/STD leave claims and regulatory-compliant adjudication.
United StatesWhat I'm looking for
I’m an Integrated Claims Specialist and Disability and Leave Claims professional with 11+ years of end-to-end Short-Term Disability (STD) and Paid Family Medical Leave (PFML) claims management at Lincoln Financial. I serve as a subject matter expert for claim adjudication, eligibility determination, and benefit calculations across multiple state and federal leave programs, with a focus on accuracy and empathetic, clear communication.
I review and assess medical documentation, develop return-to-work plans, and coordinate with claimants, HR partners, medical providers, and third-party administrators to obtain what’s needed for compliant decisions. Known for handling sensitive medical and personal information with strict confidentiality, I also stay current on FMLA, ADA, ERISA, HIPAA, and state leave laws—updating workflows and maintaining consistent compliance while managing multi-priority caseloads and claim status reporting.
Experience
Work history, roles, and key accomplishments
Manage end-to-end Paid Family Medical Leave (PFML) and Short-Term Disability (STD) claims, ensuring accurate, timely adjudication and compliance with federal and state leave regulations. Serve as a subject matter expert for eligibility, benefit calculations, and empathetic claimant communication while coordinating with HR partners, medical providers, and third-party administrators.
Adjudicated an active Short-Term Disability caseload by reviewing medical documentation, determining eligibility and benefits, and developing personalized return-to-work plans. Collaborated with claimants, medical providers, and HR partners while maintaining strict confidentiality and providing clear explanations of claim outcomes and plan provisions.
Resolved customer issues in a high-volume call environment by handling sensitive account and payment requests with accuracy and empathy. Processed transactions such as payment method changes, lien releases, misapplied payment corrections, and account closures, while supporting escalations and service-level goals.
Customer Service Representative
Nco Group
May 2005 - Feb 2009 (3 years 9 months)
Provided customers with delivery and rate information while coordinating daily UPS driver pickup schedules. Managed time-sensitive logistics work to support smooth pickups and maintain customer satisfaction through accurate, responsive communication.
Education
Degrees, certifications, and relevant coursework
Southwest Guilford High School
High School Diploma, Secondary Education
Earned a High School Diploma from Southwest Guilford High School.
Availability
Location
United StatesAuthorized to work in
Job categories
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