Crystal Dawson

Integration and Implementation Oversight:

• Oversaw multiple integration teams to ensure successful project execution and seamless client implementations.
• Develop and implement processes to improve the efficiency and accuracy of file feeds, including monitoring, triaging, and repairing feeds.
• Establish and enforce best practices for EDI file processing flows, particularly in the healthcare industry.
• Work cross-functionally to align integration efforts with business objectives and client needs.

Operational Productivity & Process Refinement:

• Design and implement processes to enhance efficiencies within the department and across teams.
• Execute data-driven insights to enhance workflows and boost customer experience.
• Enhance scalability by constructing teams and processes capable of supporting seasonal variations in demand.
• Recruit, train, and develop high-performing integration teams.

Technology and Systems Coordination

• Implement and manage tools to monitor and improve file feed processing.
• Partner with IT and engineering teams to refine integration workflows and troubleshoot technical difficulties.
• Employ Atlassian tools Jira, Confluence to oversee projects, monitor issues, and record essential processes.
• Utilized advanced technical skills and expertise to troubleshoot complex problems and implement solutions.

Unemployment Claims Specialist:

• Provided guidance and assistance to claimants in completing applications.
• Advised claimants about their rights under the applicable state law.
• Conducted 1:1 interviews with unemployment insurance claimants by telephone to gather reasons for separation from employment and finalize claim process.
• Performed initial review to determine eligibility of applicants for unemployment benefits.

Identity Fraud Risk Management Actions:

• Identified fraud cases through detailed examination of claimant's documents.
• Responded to inquiries regarding unemployment insurance regulations, laws, policies, procedures, and claims status.
• Processed appeals on denied or overpaid claims.
• Reduced fraudulent claims by conducting thorough investigations and collaborating with law enforcement agencies.

Personnel Administration

• Calculated weekly benefit amounts according to established guidelines.
• Monitored progress of pending cases in order to ensure timely resolution.
• Collaborated with various departments within the organization to ensure compliance with all legal requirements pertaining to UI matters.
• Analyzed financial records and other documentation to determine entitlement to benefits.

Staff Management

• Handled telephone inquiries by routing calls and relaying messages to relevant personnel.
• Oversaw direct incoming mail operations and coordinated outgoing mail for scheduled pickup.
• Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
• Recognized by management for providing exceptional customer service.

Direct office support

• Prepared reports on various projects for management review.
• Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
• Managed databases and records for client information and company operations.
  Developed and implemented schedules to optimize resource allocation.
• Administered company budgets to maintain fiscal responsibility.
  Interacted with staff and guests to strengthen workplace culture.

Claims and Billing Management

• Resolved discrepancies between customers' remittances and invoices received.
• Investigated incorrect billings and processed refunds as necessary.
• Performed additional duties as assigned by management team.
• Monitored accounts receivable activity to ensure timely payment of invoices.