Andrea Anderson
Lawrenceville,GA
Summary
Motivated Fraud Analyst touting 5 years of expertise investigating suspicious activity in all facets of banking/finance life cycle; blended with experience in BSA/OFAC regulations, and financial crimes. Versed in applicable audit processes, procedures, and risk management in healthcare administration. Industrious with a solid 20-year top performance in customer service and team leadership.
Overview
17
17
years of professional experience
Work History
Clinical Administrator
Revive Spine And Pain Care
01.2023 - Current
- Verify and reconcile service charges with insurance companies and payment providers.
- Maintain knowledge of standardized medical billing codes.
- Assemble charts for new patients, confirming the inclusion of requested medical history and diagnostic information.
- Manage patient scheduling and rescheduling of approximately 240 patients per month.
- Schedule procedures, new patients, and follow-ups including managing pre-certifications, and verifying insurance coverage.
- Maintain high-level knowledge of federal and Georgia regulations on patient privacy.
- Responsible for tracking, coordinating, and communicating patient referrals, personal injury claim cases, and workman’s compensation claim cases. Oversee requests from third-party referral sources and provide relevant information.
Fraud Investigator Analyst Senior Level II
Guidehouse Managed Services
02.2022 - 01.2023
- Analyzed and investigated Paycheck Protection Program machine learning case files flagged for fraud alerts and suspicious activity administered by the SBA.
- Performed detailed background checks on individuals and entities suspected of fraudulent activity to gather critical information needed for successful investigations.
- Conducted more in-depth financial investigation that included extensive research, analysis of financial statements, loan applications, deciphering of payroll records, payroll summary reports, business tax records, and bank statements for inaccuracies, misrepresentations, fraud, and program abuse.
- Reviewed and dispositioned 75 weekly manual and system-generated alerts/cases/files to mitigate risk associated with fraud.
- Analyzed time-sensitive data utilizing a variety of publicly available resources and documented conclusions and findings in SAR.
- Maintained a high level of confidentiality when handling sensitive information, protecting both company reputation and client privacy.
Fraud Investigator
Cushman & Wakefield
02.2020 - 02.2022
- Reviewed and analyzed all SBA Paycheck Protection Program business and personal loans to determine loan eligibility and examine the intended use of proceeds to make recommendations in loan decisions.
- Reviewed and evaluated borrowers’ credit, loan application, bank statements, payroll summary reports, profit and loss statements, and loan calculation reports for loan eligibility adhering to the SBA Interim Final Rules.
- Reviewed and completed amendments and modifications to the loans as needed.
- Updated ETRAN with service action changes in accordance with the SBA’s servicing matrix as needed.
- Completed (SAR) filings for fraudulent loans that did not adhere to the SBA Paycheck Protection Program Interim Final Rules.
- Responded to email/phone inquiries and communicated efficiently to bankers, branch managers, Project Managers, and colleagues about updated SBA guidance and training.
- Multi-tasked assisting with multiple projects including 7(a) loan servicing, liquidation actions, tax fraud, payroll fraud, and mortgage loan fraud.
Client Onboarding AML Analyst
Truist Bank
07.2019 - 12.2019
- Conducted AML alert/case reviews to mitigate risk associated with financial crimes and suspicious activities.
- Reviewed KYC documentation and performed (EDD) Enhanced Due Diligence on customers that were deemed high-risk.
- Determined and implemented additional steps, validating KYC risk compliance based on research of customer records, verification of account purpose and legitimacy, and analysis of transaction activity.
- Managed inbound calls from front-line unit and client call center teammates providing training assistance with Subject Matter Expertise and thorough account procedure documentation/maintenance, Bank Secrecy Act, and AML policy procedures and systems.
- Adhered to bank policy involving BSA/AML and OFAC compliance activity monitoring including SAR for high-risk customer reviews.
Chart Auditor
Northside Hospital Forsyth
11.2012 - 07.2019
- Provided detailed documentation on audit findings, facilitating swift corrective action when necessary.
- Maintained confidentiality, handling sensitive information discreetly throughout all stages of the audit process.
- Ensured compliance with regulatory requirements by performing regular audits and staying up-to-date on industry standards.
- Streamlined audit processes, improving efficiency and reducing time spent on each audit engagement.
- Reported risks identified to the appropriate team or management. Additionally, managed, monitored, and reported risks including information security risks.
- Entered and retrieved all patient chart data, corrected missing or incorrect data, and oversaw dissemination of patient chart information to physicians, patients, and other requestors.
AML Compliance Analyst
NCO Financial Systems
05.2007 - 11.2012
- Completed analysis of banking transaction information to identify risks, trends, and potential suspicious activity.
- Evaluated customer profiles and client data to assess the consistency of activity with typical purchasing/payment behaviors, including compliance with Acceptable Use Policies and Know Your Customer protocols.
- Researched and investigated alerts and effectively obtained information and assistance from appropriate law enforcement agencies, peer banks, and other external groups on AML issues.
- Documented findings in narrative format within a machine learning case management system and provided updates to management and team leads.
- Interfaced with bankers to obtain information related to their client's transaction activity.
Education
Associate of Science - Business Administration And Management
American InterContinental University
Schaumburg, IL03.2012
Skills
- Clinical Leadership
- Clinical Workflow Optimization
- HIPAA Compliance
- Anti-Money Laundering
- Fraud Detection
- Transaction monitoring
- Dispute Resolution
- Financial crimes
- Report Writing
- Effective Communication
- Verbal and written communication
- Case Management
Timeline
Clinical Administrator
Revive Spine And Pain Care
01.2023 - Current
Fraud Investigator Analyst Senior Level II
Guidehouse Managed Services
02.2022 - 01.2023
Fraud Investigator
Cushman & Wakefield
02.2020 - 02.2022
Client Onboarding AML Analyst
Truist Bank
07.2019 - 12.2019
Chart Auditor
Northside Hospital Forsyth
11.2012 - 07.2019
AML Compliance Analyst
NCO Financial Systems
05.2007 - 11.2012
Associate of Science - Business Administration And Management
American InterContinental University
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