Work History
Summary
Overview
Education
Skills
Timeline
Generic
Reg Bowles

Reg Bowles

Risk Analyst
Peoria,AZ

Work History

<p>Risk Analyst</p> <p></p>

Humboldt Merchant Services
11.2020 - 06.2025
  • Monitored a portfolio of accounts for abnormalities.
  • Identified and investigated inconsistent transactions with Card Issuing Banks,
  • Analyzed merchant activities to identify risks and made risk recommendations, such as account holds, reserve increases, and account closure.
  • Monitored merchant transactions and chargeback activity.
  • Communicated with merchants being audited. Spoke to agents and merchant customers to complete merchant audits to identify liabilities.
  • Made decisions regarding merchant payments and reserve requirements, through daily review and tracking of merchant exceptions, utilizing processing platforms, risk systems, and related reports.
  • Consulted with appropriate law enforcement agencies when required.
  • Learned and maintained a basic understanding of card brand regulations.
  • Communicated to merchants for account restrictions and cancellations.
  • Utilized Internet tools to gather information useful in determining account risk.
  • Maintained current knowledge and proficiency with all applicable, federal and state laws, regulations and guidance, such as UDAAP, Dodd Frank Act, Regulations E, and Z, and those related to Anti-money Laundering (i.e. Bank Secrecy Act, USA Patriot Act, OFAC, etc.), while implementing the most effective means of meeting the company's transaction analysis and reporting requirements.
  • Monitored collections efforts to ensure loss mitigation.
  • Took lead in in-depth risk investigations and reporting.
  • Analyzed financial statements to assess merchant solvency.

<p>AML Analyst</p> <p></p>

AML RightSource
04.2019 - 06.2020
  • Monitored transactions on assigned accounts to assess potential suspicious activity, such as money laundering.
  • Identified data anomalies as they related to AML initiatives, AML/BSA regulations, and industry best practices for AML/BSA analysis.
  • Worked effectively with multiple, complex data sources and technical analytical tools, in Transaction Monitoring, Alert Backlog Management, and Enhanced Due Diligence Reviews.
  • Assisted other members of the Compliance Unit adhere to and comply with all applicable, federal and state laws, regulations and guidance, including those related to Anti-money Laundering (i.e. Bank Secrecy Act, USA Patriot Act, etc.), while implementing the most effective means of meeting the company's transaction analysis and reporting requirements.

<p>CLAIMS ADVISOR</p> <p></p>

ESURANCE
11.2018 - 03.2019
  • Obtained information for the investigation of the facts of loss, to make a liability determination.
  • Used proprietary systems to evaluate the facts of loss and the impact on liability.
  • Resolved claims by determining "at fault" for damages, and also interpreted and explained policies and coverages to clients.
  • Assigned material damages for inspection to the proper appraisal sources; resolved vehicle damage claims, including total losses determined by the Material Damage Department.
  • Negotiated with clients, claimants, and witnesses for resolution of claims
  • Partnered with our internal auto appraisers to manage vehicle repairs, and assisted with rental car procurement.
  • Identified exposures and referred files for triage to the appropriate level, including injury claims.
  • Documented files which included all key activities, contacts made, and statements taken for the resolution and processing of claims with the Esurance Claims System.

<p>BENEFITS SPECIALIST</p>

ADP
11.2017 - 11.2018

  • Administered, managed and/or governed a variety of benefit plans on a day-to-day basis through processing of

    various transactions and events within and potentially outside of the Total Source systems, including but not limited

    to pending enrollments, dependent verification, new hire, life and termination events and annual open enrollment

    processing.

  • Performed various data integrity and enrollment/eligibility audits. Researched and resolved issues identified through

    those routine audits.


  • Reviewed, maintained, and modified standard operating and client operating processes and procedures for benefits

    administration. Identified opportunities for potential improvement in enrollments and benefits administration.


  • Made recommendations to management and peers.Managed and monitored data flow and integration including

    carrier connections, payroll and/or processes manual carrier updates.


  • Worked in conjunction with various team members to resolve errors and issues in a timely and accurate manner.

    Escalated programmatic issues to appropriate team members, carriers or HRBPs, as appropriate.


  • Developed and implemented the workflow (both manual and electronic) to ensure that the transactions are accurately

    processed by TotalSource service providers such as Section 125/FSA, COBRA, 401(k), etc.


<p>BENEFITS ADMINISTRATOR</p> <p></p>

CONDUENT
01.2017 - 01.2017

  • Proficiently administered Defined Benefits (Pension), and Health & Welfare benefit plans (medical, life insurance,

    COBRA, flexible spending accounts, etc.).

  • Proficient in Kforce, Tasknet, and Advantage.


  • Superior ability to work autonomously, with little direct managerial supervision.
  • Outstanding organizational and time management skills, with the ability to handle multiple tasks simultaneously.

<p>CLAIMS SPECIALIST</p> <p></p>

STATE FARM
01.2016 - 01.2017

  • Handled inbound calls and exercised good decision-making skills in reviewing information, issuing payments and

    resolving claims.

  • Communicated with customers in a courteous manner using approved scripts as needed via phone or written

    correspondence.


  • Worked from established procedures and job aids and handled multiple computer applications while helping

    customers on the phone.


  • Educated customers on the claims process.


  • Maintained quality, accuracy and professionalism in a fast-paced environment.

<p>MEDICARE PROVIDER ENROLLMENT ANALYST</p>

FIRST COAST SERVICE OPTIONS
01.2015 - 01.2016

  • Successfully controlled and tracked provider enrollment to ensure compliance with State, Federal, and Medicare

    regulations.

  • Used sound research, analytical and decision-making skills to appropriately approve provider enrollment.


  • Identified cases of suspected fraud and resolved complex provider enrollment issues.

  • Managed multiple stages of development in provider enrollment through the use of national databases, proprietary

    software applications, and internal ISO work flows.

  • Monitored multiple databases to track provider enrollment and also used proficient skills in Microsoft Word and

    Excel to manage the provider enrollment process.


Summary

An experienced business professional, with a strong track record of performance-driven, team-oriented, success. Strong written and verbal communication skills, with extensive experience interacting with small, medium, and large external customers. Successfully used exemplary decision-making and problem-solving skills across the following business sectors: Government, Healthcare, Insurance, Financial Technology , Merchant Services

Overview

15
15
years of professional experience

Education

Management

University of Phoenix,
Jacksonville, FL

Business Administration

University of North Florida
Jacksonville, FL

Skills

    Problem-Solving

undefined

Timeline

Risk Analyst

Humboldt Merchant Services
11.2020 - 06.2025

AML Analyst

AML RightSource
04.2019 - 06.2020

CLAIMS ADVISOR

ESURANCE
11.2018 - 03.2019

BENEFITS SPECIALIST

ADP
11.2017 - 11.2018

BENEFITS ADMINISTRATOR

CONDUENT
01.2017 - 01.2017

CLAIMS SPECIALIST

STATE FARM
01.2016 - 01.2017

MEDICARE PROVIDER ENROLLMENT ANALYST

FIRST COAST SERVICE OPTIONS
01.2015 - 01.2016

Management

University of Phoenix,

Business Administration

University of North Florida

Similar Profiles

CREATE PROFILE
Reg BowlesRisk Analyst
Profile made at Zety.com