Open to opportunities

Troshella Mickle

@troshellamickle

Message

HR Benefits & LOA specialist improving compliance, claims, and employee leave support.

United States

Message

What I'm looking for

I’m looking for a benefits-focused HR role where I can own leave-of-absence and benefits administration, ensure compliant, accurate processing, and support employees through clear communication—while partnering with vendors and HR teams to improve satisfaction.

I’m a seasoned HR Benefits/LOA Specialist with several years of experience in benefits administration, health insurance claims, retirement plans, and wellness initiatives. In my current role at Southwest Behavioral Health Services, I administer employee benefits (including health insurance and retirement plans) while ensuring compliance and improving employee satisfaction. I also oversee open enrollment annually and process life events, including regular audit checks on 403b deferrals.

I manage leave of absence administration end-to-end—maintaining accurate records, counseling employees on leave processes and ADA accommodations, and coordinating with leave management vendors to process STD and LTD claims under FMLA. Previously, I strengthened my customer-focused, high-accuracy healthcare background through prior authorization and complex authorization work using ICD-10 and CPT codes, along with HIPAA-adherent member support—always prioritizing clear communication, problem-solving, and data integrity.

Experience

Work history, roles, and key accomplishments

Current

HR Benefits/LOA Specialist

Current

Southwest Behavioral Health Services

Dec 2024 - Present (1 year 4 months)

Administer employee benefits including health insurance and retirement plans, ensuring compliance with regulatory requirements. Manage leave of absence administration and coordinate STD/LTD claims and open enrollment activities while counseling employees on processes and ADA accommodations.

Benefits Administration FMLA & Compliance Employee Relations Vendor Management

Benefit Specialist

Accolade

Feb 2020 - Aug 2024 (4 years 6 months)

Facilitated communication between employees and insurance carriers to resolve claims and billing issues and support benefit eligibility and enrollment. Collaborated on escalated cases with nursing support to help meet monthly performance targets.

Claims Resolution Billing Support Eligibility Verification Performance Metrics Customer Support

Complex Authorization Specialist

TriWest Health Alliance

Jan 2018 - Jan 2020 (2 years)

Analyzed and processed authorization requests using ICD-10 and CPT codes to ensure timely access to external healthcare services for veterans. Coordinated with providers to obtain medical records and maintained data integrity for eligibility and VA consult report preparation.

Authorization ICD 10 Coding CPT Coding Medical records retrieval Data Integrity Eligibility Verification Service Coordination Veteran Services Documentation Review

Member Service Representative

Teladoc Inc

Jan 2015 - Oct 2017 (2 years 9 months)

Provided personalized solutions to resolve member inquiries while adhering to HIPAA regulations. Guided members through insurance verification, registration, and consultation scheduling, including technical troubleshooting and payment processing to support a seamless pre-appointment experience.

Customer Service HIPAA compliance Insurance Verification Scheduling Technical Troubleshooting ICD Code Verification Payment Processing

Prior Authorization Specialist

Magellan Health Services

Mar 2013 - Sep 2014 (1 year 6 months)

Processed benefits investigations and verified eligibility while managing over 90 professional inbound calls daily to produce accurate medical documentation and insurance quotes. Expedited prior authorizations and supported appeal workflows, including prompt case identification and provider peer-to-peer scheduling.

Prior Authorizations Eligibility Verification Benefits Investigation Inbound Call Management Insure Quote Appeals Provider Peer To Peer Scheduling Medical Documentation