Detail-oriented professional committed to improving organizational outcomes by monitoring performance initiatives. Focused on planning, implementing, and optimizing procedures. Specializing in operations and dedicated to maximizing quality. Known for high productivity and efficiency in task completion. Possess specialized skills in data analysis, pattern recognition, and risk assessment. Excel at problem-solving, critical thinking, and decision-making to identify and mitigate risk.
Overview
9
9
years of professional experience
Work History
Delivery Driver
Arizona Home Care
02.2019 - Current
Safely transport and deliver medical equipment, supplies, and medications to hospice patients, ensuring timely and accurate delivery according to scheduled needs.
Communicate with patients and their families with compassion and professionalism, addressing any questions or concerns regarding deliveries.
Maintain accurate records of deliveries, including patient signatures, inventory logs, and any issues encountered during transport.
Work closely with nursing and administrative staff to coordinate delivery schedules and respond to urgent needs as required.
Adhere to all relevant safety and regulatory standards, including HIPAA regulations regarding patient confidentiality.
Quality Analyst I and II
Early Warning Services (Zelle)
Phoenix, AZ
02.2018 - 01.2022
Customer Support:
Provide support to internal and external customers, researching and resolving issues according to documented procedures and escalating to appropriate on-call staff as needed.
Assists in development of self-service tools, by providing accurate categorization, prioritization of all customers contacts via our Customer Relationship Management tool (CRM).
Monitoring and Process Control:
Monitor all production applications, and internal systems: to ensure the delivery of all input, and output files is successfully.
Monitor all systems, network, and applications components for operational stability.
Responsible for identifying and tracking gaps in operational analytics protocols to assist in the creation of automated, and practical solutions.
Incident Management:
Identify and report system, application and network issues ensuring all events are entered into the ticket tracking application.
Track and monitor escalated issues to ensure proper and timely resolution.
Providing clear and concise communication, documentation, and severity trending.
Support the company’s commitment to risk management and protecting the integrity and confidentiality of systems and data
Knowledge Management:
Create and maintain documentation of operational processes to conform to audit requirements.
Thoroughly document all support events in a workflow ticketing system in a timely manner ensuring that subsequent review of any incident is effective for knowledge base utilization
Reinvestigations Specialist - Fraud Analyst
Early Warning Services (Zelle)
09.2018 - 05.2019
Assess, recommend and modify the application of scores and rules to deliver the optimal balance of risk, expense and experience for clients, consumers and partners in the network.
Implement the fraud detection strategies for the network.
Create and apply of data driven insights for constant monitoring of effectiveness, efficiency and opportunities in the application of scores, rules and logic in the execution of managing fraud risk.
Create appropriate communications to internal and external stakeholders regarding emerging risks, observed trends and related opportunities.
Perform the analysis of fraud events for the purpose of identifying and consistently categorizing the root cause of fraud events observed or attempted in the network.
Support the company’s commitment to protect the integrity and confidentiality of systems and data.
Specialty Health Contractor
Specialty Health Contractor
10.2015 - 02.2018
Maintain and update patient records, ensuring accuracy and confidentiality in compliance with HIPAA regulations.
Assist with the coding of patient diagnoses and procedures for insurance claims, ensuring accurate billing processes and timely submission.
Ensure adherence to healthcare regulations and standards, conducting regular audits to maintain compliance.
Serve as a point of contact for patients, addressing inquiries and resolving issues related to their care and billing.
Input and manage patient data in electronic health record (EHR) systems, ensuring data integrity and accessibility.
Collaborate with healthcare providers and administrative staff to streamline operations and enhance patient care.
Participate in training sessions to stay updated on best practices in healthcare administration and compliance.
Skills
Customer Service Excellence
Fraud Detection and Analysis
Problem Solving and Critical Thinking
Data Analysis and Reporting
Communication and Interpersonal Skills
Time Management and Organization
Logistics knowledge
Exceptional written and verbal communication skills
Account information review
Risk level determination
Data Analysis
Dispute Resolution
Activity monitoring
FCRA Certification
Accomplishments
Promoted multiple times at Early Warning due to exceptional performance
Worked and trained cross functionally as both a fraud and quality analyst at Early Warning due to strong ability to adapt to new processes and implement change quickly and efficiently.