Brea Pillow
Nashville,TN
Summary
Motivated and detail-oriented professional with a strong desire to secure an HR Specialist position. Eager to utilize exceptional organizational and interpersonal skills to effectively support HR operations, streamline processes, and foster a positive work environment. Passionate about performing support duties and efficiently handling various tasks within the HR department.
Overview
15
15
years of professional experience
Work History
HR Operations Vetting Specialist
UBS Financial
11.2023 - Current
- Responsible for conducting criminal background checks, educations verification, and employment history verification to ensure the candidate’s integrity and qualifications
- Responsible for conducting electronic record checks in support of vetting investigations on classified databases
- Provide background on items discussed by the vetted applicant and point out possible irregularities between applicants documented information and information provided orally
KYC Client Onboarding Analyst
UBS Financial
11.2022 - 11.2023
- Responsible for onboarding new and existing client opportunities to the firm, while accurately identifying and escalating any potential risk concerns
- Responsibilities include reviewing client documentation relative to control and ownership, running background checks to properly identify reputational or transactional risk, reviewing and ensuring proper regulatory obligations based on product area have been met, among other data relative points
Medical Registration and Authorization Specialist/SME
Philips Lifeline
11.2019 - 11.2022
- Obtaining and entering Medicaid authorizations for treatment from various payers and following up on authorization requests, running reports, and identifying expiring authorizations
- Accurately maintaining patient files and current authorization information
- Coordinating with various locations regarding authorization statuses and assist with insurance verification and other billing office related activities
- Reviewing claims for the accuracy of procedures, diagnoses, demographic and insurance information
- Training new hires and assisting with the onboarding process
Clinical Administrative Coordinator
UnitedHealthcare
02.2018 - 11.2019
- Ensuring all letters comply with all applicable State and Federal Laws and Consent Decrees, as well as the Accrediting Regulatory Review Agencies, including but not limited to CMS, NCQA, HIPAA, and all UHC Policies and Procedures
- Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance
- Drafting of NOA / NOE letters for government and Commercial Specific clients
- Responsible for ensuring the letter documentation meets client, regulatory and accreditation requirements
- Knowledge of the State and Federal regulations concerning the services and benefits
- Must demonstrate understanding of the program (Prior Authorizations, etc
- Medicaid, Medicare) by selecting the correct letter template
- Other duties as assigned by manager and / or director
- Elevated to a special project team handling the department’s high-profile clients to deliver top quality metrics on high SLA contracts
- Work as a resource to my peers and a cross functional asset to the team
Associate Clinical Administrative Coordinator
UnitedHealth Group-Optum
06.2015 - 02.2018
- Inbound/outbound calls to Medicare members to schedule annual preventative care visits and coordinate Nurse Practitioner calendars and appointments
- Elevated to a special project team handling the department’s high-profile clients to deliver top quality metrics on high SLA contracts
- Work as a resource to my peers and a cross functional asset to the team
- Data entry and performing a variety of other office tasks such as, faxing or emailing
VA Choice Representative, A&A Analyst
CGS Administrators
10.2014 - 02.2015
- Answering inbound calls from Veterans regarding VA Choice program
- Supported veterans via inbound call coverage in benefit and VA choice program options
- Approving authorization forms faxed from the VA
Administrative Assistant
Vaughn’s Home Improvements
05.2010 - 06.2013
- Provided secretarial duties that consisted of filing, creating invoices/contracts, and general correspondence
- Responsible for administrative office operations and procedures, designed filing systems and generated necessary legal documents in accordance with local and state home improvement
- Coordinate schedules/appointments; conduct Human Resource procedures such as interview/hiring and new employee orientation
- Counsels/coaches employees in implementing and achieving goals
- Effectively manage conflicts related to the workplace
- Other job duties include executing and planning workforce-maintaining strategies, maintaining records that pertain to company requirements and job responsibilities
- Property Management: Conducted periodic property inspections, addressed resident concerns and requests (i.e
- Maintenance, personal and community issues) on a timely basis to ensure satisfaction
Education
Business Administration -
Nashville State Community College
Nashville, TNHS Diploma -
Hillsboro High School
Nashville, TN05-2014
Skills
- Active listening
- Communication skills
- Conflict Resolution and Problem-Solving
- Critical Thinking
- Data Analytics and Reporting
- Escalated call handling
- HR Software
- Leadership Skills
- Software proficiency
- Project management
Timeline
HR Operations Vetting Specialist
UBS Financial
11.2023 - Current
KYC Client Onboarding Analyst
UBS Financial
11.2022 - 11.2023
Medical Registration and Authorization Specialist/SME
Philips Lifeline
11.2019 - 11.2022
Clinical Administrative Coordinator
UnitedHealthcare
02.2018 - 11.2019
Associate Clinical Administrative Coordinator
UnitedHealth Group-Optum
06.2015 - 02.2018
VA Choice Representative, A&A Analyst
CGS Administrators
10.2014 - 02.2015
Administrative Assistant
Vaughn’s Home Improvements
05.2010 - 06.2013
Business Administration -
Nashville State Community College
HS Diploma -
Hillsboro High School
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