Crystal Rivera
Irving,Texas
Summary
Proven Program Manager with a track record of enhancing fraud detection and payment security at Advanced Online Strategies. Expert in cross-functional collaboration and strategic planning, I've led teams to significantly reduce fraud risks. Skilled in documentation and adept at fostering teamwork, my initiatives have consistently improved operational efficiency and safeguarded company assets.
Overview
9
9
years of professional experience
Work History
Retention Specialist
Liberty Mutual
09.2021 - Current
- Customer account monitoring: Regularly reviewed customer accounts to identify signs of potential dissatisfaction or fraudulent activity, ensuring proactive intervention.
- Payment reconciliation: Managed the reconciliation of customer payments, addressing discrepancies and ensuring accurate records.
- Fraud detection: Identified suspicious account behaviors and transactions, working closely with fraud prevention teams to mitigate risks.
- Data analysis: Analyzed customer behavior data to detect patterns that may indicate fraud or account misuse, providing insights to the fraud prevention team.
- Customer outreach: Engaged with customers flagged for unusual activity, gathering information to confirm account security and authenticity.
- Compliance management: Ensured all customer interactions and payment processes adhered to legal and regulatory requirements.
- Problem resolution: Addressed and resolved complex issues related to payments and account security, maintaining customer trust and minimizing loss.
- Collaborative efforts: Worked with fraud specialists and payment processing teams to refine strategies for preventing fraudulent activities.
- Documentation: Maintained accurate records of all interactions, fraud investigations, and resolution steps taken, ensuring traceability.
- Process optimization: Suggested improvements to retention and fraud detection processes to enhance efficiency and reduce fraud-related incidents.
Claims Adjuster
State Farm
08.2017 - 05.2021
- Claims investigation: Conducted thorough investigations into claims, gathering and analyzing evidence to determine validity and prevent fraudulent activities.
- Fraud detection: Identified suspicious claims and collaborated with fraud specialists to mitigate risk and prevent losses.
- Payment processing: Managed the approval and processing of claim payments, ensuring accuracy and adherence to company guidelines.
- Data analysis: Reviewed and analyzed claim data to detect patterns and anomalies that could indicate fraudulent behavior.
- Compliance enforcement: Ensured all claims were processed in compliance with industry regulations and company policies.
- Stakeholder communication: Liaised with claimants, legal representatives, and internal teams to resolve disputes and ensure transparency in the claims process.
- Risk assessment: Evaluated claims to assess potential risks and recommended actions to minimize financial exposure.
- Documentation and reporting: Maintained detailed records of claims investigations and outcomes, providing comprehensive reports to management.
- Claims resolution: Negotiated settlements and resolved claims efficiently, balancing customer satisfaction with company interests.
- Continuous improvement: Suggested process improvements to enhance the efficiency of claims handling and reduce the likelihood of fraud.
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
Program Manager
Advanced Online Strategies
03.2016 - 08.2017
- Managed and supervised administrative and daily program operations, complying with policies and regulations.
- Fraud detection oversight: Led initiatives to identify, investigate, and prevent fraudulent activities, safeguarding company assets and customer information.
- Payment process optimization: Managed and streamlined payment processing systems, ensuring secure and efficient transactions across all platforms.
- Cross-functional collaboration: Coordinated with finance, IT, and legal teams to implement fraud prevention strategies and enhance payment security.
- Risk management: Developed and executed risk mitigation plans, addressing potential vulnerabilities in payment processes.
- Data analysis and reporting: Analyzed transaction data to detect patterns of fraud, producing detailed reports for senior management and regulatory compliance.
- Team leadership: Supervised and mentored a team of fraud analysts, ensuring effective training and adherence to best practices in fraud prevention.
- Vendor management: Oversaw relationships with payment processing vendors, negotiating contracts and ensuring compliance with security standards.
- Regulatory compliance: Ensured all payment and fraud prevention activities complied with industry regulations and internal policies.
- Incident response: Led the response to fraud incidents, coordinating with internal and external stakeholders to resolve issues quickly and effectively.
- Continuous improvement: Identified opportunities for process improvements, implementing changes to reduce fraud risks and enhance payment security.
Retail Sales Associate
Nike
05.2015 - 03.2016
- Maintained a clean and organized store environment, enhancing the overall shopping experience for customers.
- Utilized exceptional communication skills to engage customers, answer inquiries, and provide personalized recommendations on products based on their needs
- Demonstrated strong product knowledge to effectively drive sales goals and exceed monthly targets by upselling and cross-selling
- Fostered positive relationships with customers to ensure a high level of satisfaction and repeat business
- Managed inventory levels to maintain a well-stocked and visually appealing store environment
- Participated in product training sessions to stay up-to-date on the latest trends and developments in the retail industry
Education
Quality Assurance Engineering
TripleTen
Online09.2024
High School Diploma -
Trinity High School
Euless, TX01.2016
Skills
- Documentation skills
- Cross-Functional Communication
- Trend tracking
- CRM software proficiency
- Data review
- Problem-Solving
- Project Management
- Detail Oriented
- Strategic Planning
- Teamwork and Collaboration
- Time management expert
- Adaptability in harsh conditions
Timeline
Retention Specialist
Liberty Mutual
09.2021 - Current
Claims Adjuster
State Farm
08.2017 - 05.2021
Program Manager
Advanced Online Strategies
03.2016 - 08.2017
Retail Sales Associate
Nike
05.2015 - 03.2016
Quality Assurance Engineering
TripleTen
High School Diploma -
Trinity High School