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Skills

  • Client communication and issue resolution
  • Operational improvement
  • Regulatory compliance
  • Fraudulent submission detection
  • Team management
  • Fraud detection and prevention
  • Data-driven decision making
  • Prior authorization processing
  • Collaborative relationships
  • Project organization

Work Experiences

  • Looked for industry trends on social media and through online sources.
  • Achieved results within 2020.
  • Collaborated with cross-functional teams to streamline the verification process, resulting in a 57% decrease in processing time.
  • Collaborated with third-party vendors to enhance data validation procedures, driving the elimination of outdated verification processes by 70%.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Addressed 66% of outstanding verification gaps.
  • Collaborated directly with law enforcement on 9 criminal investigations requiring document verification, ensuring undisputed evidence integrity.
  • Transported HubSpot to two years customer locations.
  • Achieved 35% error reduction.
  • Conducted thorough investigations.

Summaries

  • Insurance Verification Specialist with 14 years of experience explaining benefits and tracking coverage.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Achieved zero recorded violations during 2015.
  • Achieved a 29% reduction in discrepancies.
  • Collaborated effectively in cross-functional teams.
  • Costs were consistently reduced while profits were increased.
  • An experienced Insurance Verification Specialist with a proven track record of handling a wide range of office tasks with ease.
  • Professional with experience verifying insurance benefits and generating appropriate patient documentation.
  • Achieved 38% reduction in violations.
  • Adept at reducing risks.

Accomplishments

  • Drafted and implemented verification protocols that reduced data entry errors by 33%, increasing overall verification accuracy.
  • Presented results from weekly verification checks to senior executives, allowing for real-time adjustments to compliance protocols.
  • Updated error reduction procedures that cut down verification discrepancies by 37% while maintaining process integrity.
  • Identified and resolved 18 verification discrepancies linked to high-risk accounts within several months, averting potential fraud risks.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Developed comprehensive fraud detection training materials, leading to a decrease in fraudulent verification discrepancies by 63%.
  • Initiated the enhancement of verification documentation flow, resulting in a 55% improvement in efficiency.
  • Leveraged SAP to optimize verification data sorting, which reduced time spent on manual tasks by 32% hours weekly.
  • Coordinated with compliance teams to ensure verification standards met OSHA guidelines, minimizing audit findings by 84%.
  • Collaborated with method to integrate predictive algorithms, reducing false-positive verifications by 23%.

Affiliations

  • Certified Information Systems Auditor (CISA)
  • Certified Information Security Manager (CISM)
  • International Association of Privacy Professionals (IAPP)
  • Jaycees
  • Financial Industry Regulatory Authority (FINRA) Certifications
  • National Association of Social Workers
  • American Bar Association – Business Law Section
  • Data Science Council of America (DASCA)
  • Association of Workplace Investigators (AWI)
  • Freemason

Certifications

  • Certified in Risk Management Assurance (CRMA)
  • CLEAR: National Law Enforcement Telecommunications System Certification
  • Certified Compliance and Ethics Professional (CCEP)
  • Certified Compliance Specialist (CCS) - Meridian
  • Cisco Certified Internetwork Expert (CCIE)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Specialist in Security Verification Procedures (CSSVP) - Vantage
  • Microsoft Certified Systems Engineer (MCSE)
  • Remote Identity Proofing Certification - initiative
  • Certified Data Privacy Solutions Engineer (CDPSE)

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