Ayzjohnna Betts
Summary
Experienced Auditor focused on improving business compliance, workflow and processes through detailed audits and optimization recommendations. Successful track record of fully evaluating information, structures and procedures and initiating corrective actions. Dedicated professional eager to create and implement successful strategies to improve organizational efficiency.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Membership Auditor
BlueCross BlueShield of SC
09.2024 - Current
- Audit group accounts to ensure premium payments and reimbursements are processed in a timely manner
- Ensured compliance with regulatory requirements by performing regular audits and staying up-to-date on industry standards.
- Help offer an end-to-end ICHRA solution, from enrollment, employee communications and onboarding to reporting and compliance to claims processing to ongoing customer support
- Maintained confidentiality, handling sensitive information discreetly throughout all stages of the audit process.
- Streamlined audit processes, improving efficiency and reducing time spent on each audit engagement.
- Review membership records to verify accuracy, ensuring compliance with membership requirements
Human Resources Generalist
Spectrum
12.2021 - 08.2024
- Provide day-to-day generalist support of People services; respond to general employee questions related to benefits, company policies and procedures
- Enroll new employees in benefit plans in HRIS and provides benefits orientation
- Support Health & Wellness programs and events, including annual open enrollment Respond to employee inquiries regarding coverage and addresses these issues with carriers.
- Respond to employee issues in compliance with HIPAA, Section 125 and State laws.
- Process open enrollment benefit plan transfers. Issue annual individual summary of benefits to employees.
- Support and continuously improve the onboarding process Ensure compliance with all federal and state regulations; keep up to date on employment law and current best practices to help better facilitate the employee experience.
- Support compliance activities as needed Updated HR database with new employee information, changes in benefits, and other details.
Billing Specialist/ CNA
Samaritan Health Services/ CNA
06.2021 - 12.2021
- Assist and learn from our well experienced biller.
- Review and analyze medical documentation to ensure accurate coding and billing.
- Assign appropriate codes to diagnoses and procedures using ICD-10 coding system.
- Verify patient insurance coverage and obtain necessary authorizations for services.
- Prepare and submit claims to insurance companies electronically or by mail.
- Follow up on unpaid claims and denials, and appeal when necessary.
- Maintain patient billing records and update information as needed.
- Answer patient inquiries regarding billing and insurance coverage.
- Collaborate with healthcare providers to resolve coding or billing issues.
Account Specialist
Suddenlink Communications
11.2019 - 06.2020
- Present products and services directly to prospective customers utilizing promotional sales techniques and quality-focused sales methods.
- Deliver engaging product presentations that positively impact the customer's lifestyle and current situation.
- Act as a primary point of contact between new customer accounts and our clients to create and sustain a positive sales experience while driving new customer retention.
- Communicate policy updates, upgrades and product knowledge accurately and clearly.
- Handle and advise customer accounts using a pre-vetted set of customers to qualify potential new customers.
- Demonstrate proficient knowledge of products and services to drive opportunities for upselling.
- Utilize organizational skills to track all customer interactions and file in accordance with our customer confidentiality requirements.
Horizontal Engineer Construction
S4/DTS
08.2018 - 03.2019
- Developed cost estimates and project specifications for proposals.
- Wrote, reviewed and edited technical document in accordance with template requirements.
- Reviewed technical drawings developed by CAD technicians and drafters.
- Performed complex calculations to analyze and optimize engineering processes.
- Designed and implemented quality control processes to facilitate customer satisfaction.
- Created detailed reports on engineering activities and findings.
- Developed and maintained relationships with suppliers to facilitate quality and timely delivery of materials.
Engineer
United States Army - Indianapolis, IN
11.2016 - 03.2019
- Constructed and camouflaged infantry positions and equipment to prevent detection.
- Constructed floating bridges and temporary roadways to facilitate movement of large convoys of equipment and personnel to and from battle areas.
- Located mines through both visual means and use of mine detectors, neutralizing all enemy threats and booby traps.
- Performed quality control by creating rosters, spreadsheets and other documentation to identify company inventory.
- Repaired damaged runways, flight lines and airfield infrastructure under combat conditions to rapidly return to flight operations.
- Conducted ground reconnaissance for roads, bridges and tunnels and reported findings to commander.
Education
Bachelor of Science - Business Administration
University of Phoenix
Tempe, AZ08-2024
Associate of Arts - Accounting
Southern New Hampshire University
09-2019
Skills
- Attention to detail
- Team collaboration
- Audit reporting
- Bookkeeping
- Decision-making
Certification
- CNA
- Secret Clearance
Timeline
Membership Auditor
BlueCross BlueShield of SC
09.2024 - Current
Human Resources Generalist
Spectrum
12.2021 - 08.2024
Billing Specialist/ CNA
Samaritan Health Services/ CNA
06.2021 - 12.2021
Account Specialist
Suddenlink Communications
11.2019 - 06.2020
Horizontal Engineer Construction
S4/DTS
08.2018 - 03.2019
Engineer
United States Army - Indianapolis, IN
11.2016 - 03.2019
- CNA
- Secret Clearance
Bachelor of Science - Business Administration
University of Phoenix
Associate of Arts - Accounting
Southern New Hampshire University
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