Summary
Overview
Work History
Education
Skills
Certification
Accomplishments
Timeline
Generic

Danielle Crawford

Nampa,ID

Summary

Dedicated and adaptable professional with a proven track record of success across diverse industries. Possesses strong communication, interpersonal, and problem-solving skills, coupled with a commitment to excellence in all endeavors. A quick learner with the ability to thrive in fast-paced environments, prioritize tasks effectively, and deliver results under pressure. Seeking to leverage my versatile skill set and positive attitude to contribute value to a dynamic team and pursue new opportunities for growth and development.

Overview

17
17
years of professional experience
1
1
Certification

Work History

Loan Level Compliance Supervisor

Premier Mortgage Resources
08.2019 - Current
  • Oversees department who works and issues initial disclosures, change in circumstances and preaudits
  • Ensures that disclosures are sent out within the timeframe as dictated by the regulatory compliance guidelines
  • Ensure that all files follow program and state guidelines
  • Assist with setting up of new program and new states, guidelines, rules, regulations, and requirements
  • Initial training and on-going training for team
  • Create and update training materials and guides
  • Monitor multiple pipelines and reports to ensure all tasks are completed in timely matter and within compliance
  • Respond to inquiries from multiple departments effectively and concisely
  • Pull VA COE; order VOE’s; run AUS/DU; run flood and fraud
  • Ensures updates from Compliance, Operations and Production are communicated to the team
  • Responds to Rush Requests for disclosures sent from production and management and ensures timely completion or indicates when the request can be accommodated
  • Responds to all Post-Closing and QC Findings related to disclosures and changes in circumstance
  • Meets with Director of Operations on a regular basis to go over staffing, training, personnel issues and overall processes and procedures within department
  • Ensures that team provides coverage for production across PMR’s business hours within each time zone
  • Approves time off requests from team and posts on Operations PTO calendar
  • Works with Director of Operations and Human Resources on personnel issues within the department
  • Consistently stays on top of regulatory changes that affect her department
  • Informs Director of Operations on any errors that may affect the salability of a loan
  • Reaches out to Director of Operations &/or Compliance Manager with questions pertaining to compliant disclosures
  • Informs Director of Operations of any issues with branches or production teams.

CLAIMS ADMINISTRATOR

ACCUSERVE
05.2023 - Current
  • Claims processing, efficiently process insurance claims, including reviewing documentation, verifying coverage, and determining claim validity
  • Document management, maintain accurate records of all claims-related documents, ensuring compliance with legal and regulatory requirements
  • Communication, serve as the primary point of contact for claimants, insurance agents, and other stakeholders, providing timely and clear communication throughout the claims process
  • Investigating, conduct thorough investigations into the circumstances surrounding each claim, gathering relevant information and evidence to support claim decisions
  • Evaluate claims based on policy terms, coverage limits, and applicable regulations to determine claim settlements or denials
  • Payment processing, Coordinate the timely and accurate disbursement of claim payments, collaborating with finance and accounting departments as needed
  • Customer service, address customer inquiries and concerns regarding their claims, demonstrating empathy, professionalism, and a commitment to customer satisfaction
  • Quality assurance, Ensure the accuracy and integrity of claims data and documentation, identifying and resolving discrepancies or errors as needed
  • Identify opportunities for process optimization and efficiency enhancements within the claims management workflow, contributing to the ongoing improvement of departmental operations
  • Compliance, Stay up-to-date of changes in insurance laws, regulations, and industry best practices, ensuring compliance with all relevant guidelines and standards.

Estimator

Franklin Building Supply
06.2019 - 08.2019
  • Used specialized software to create estimates quickly and accurately and make estimates easily understandable and shareable.
  • Established a reputation for delivering reliable and accurate estimates, resulting in increased client trust and repeat business opportunities.
  • Gathered cost and material data for accurate and up-to-date information on material and labor costs.
  • Calculated labor hours accurately based on trade-specific productivity rates, leading to more realistic project timelines and work plans.
  • Prepared material orders to complete projects on time and within budget.
  • Continuously improved estimating procedures by staying updated on industry trends and attending relevant training courses.
  • Collaborated with other departments and contractors to access all necessary information and expertise to create comprehensive estimates.
  • Analyzed designs and performed accurate cost analysis.
  • Increased project accuracy by diligently reviewing specifications, drawings, and other documentation.

Purchasing and Receiving

Images Flooring
08.2018 - 05.2019
  • Prepare purchase orders, solicit bid proposals, price material lists, and review requisitions for goods and services
  • Purchase the highest quality merchandise at the lowest possible price and in the correct amounts
  • Monitor and follow applicable laws and regulations
  • Research and evaluate suppliers, based on price, quality, selection, service, support, availability, reliability, production and distribution capabilities, and the supplier's reputation and history
  • Negotiate, renegotiate, and administer contracts with suppliers, vendors, and other representatives
  • Procuring products and inventory management as requested
  • Work and maintain relationships with vendors
  • Communicate with vendors regarding delivery schedules
  • Maintain and provide accurate and current information pertaining to orders, materials status; schedule updates etc that needed to update internal team, field managers, sales reps and builders
  • Receive delivered and will-called invoiced material from warehouse into system
  • Run and update open order reports.

Pharmacy Technician Denial Specialist

Schryver Medical Group
01.2017 - 08.2018
  • Denial Management, Review and analyze denied claims from insurance payers, identifying reasons for denial and determining appropriate courses of action for resolution.
  • Claims Investigation, Conduct thorough investigations into the circumstances surrounding each denial, gathering relevant information and documentation to support claim appeals.
  • Appeals Preparation, Prepare comprehensive appeals packages, including written appeals letters, supporting medical records, and any additional documentation required for appeal submission.
  • Serve as the primary point of contact for insurance payers regarding denied claims, engaging in timely and professional communication to facilitate claim resolution.
  • Coding Review, Collaborate with coding and billing teams to ensure accurate coding and documentation practices, addressing coding-related issues contributing to claim denials.
  • Ensure compliance with all relevant laws, regulations, and industry standards governing claims processing and denial management activities.

Event Operations

Epicurian Sports
08.2016 - 11.2016
  • View and process order purchase requests for suites and assist in set up of suites with proper equipment, food and beverage based on each client’s suite requests per game or event
  • On game day expedite food and beverage requests to client’s suite
  • Inventory beverages and liquor for each suite
  • Assist with events; Event pulls of equipment, set up of event space; event breakdown and return equipment back to stewarding equipment room.
  • Streamlined event operations by developing efficient processes and coordinating cross-functional teams.
  • Supported event operations, transporting staff and equipment as needed for seamless execution.
  • Collaborated with fellow bartenders and concession staff for seamless event operations.
  • Streamlined event operations by efficiently setting up tables, chairs, and other equipment.

Pharmacy Technician Lead (SME)

Xerox - CVS Pharmacy
11.2014 - 06.2016
  • Process new insurance policies, modifications to existing policies and claims forms
  • Acquire information from policyholders to verify accuracy and completeness of information on claims forms, applications and related documents, and company records
  • Administer changes on existing policies and company records to reflect modifications requested by policyholders and insurance company representatives
  • Collaborate with medical offices to obtain further information needed
  • Supervise and guide 7 SME agents on what they should directly be working on and the areas to be assisting in
  • Analyze cases for complete accuracy prior to being submitted to client for upwards of 80 agents in office
  • Provide training programs and training materials
  • Attend meeting with upper management and other out of states sites to go over new processes and procedures.

Funder Assistant

Stearns Lending LLC
06.2014 - 08.2014
  • Kept records of materials filed or removed, using logbooks or computers
  • Responsible for adding new material to file records or creating new records as necessary
  • Performed general office duties such as typing, operating office machines, and sorting mail
  • Tracked information removed from files to ensure that borrowed files were returned
  • Collected materials to be filed from departments or employees
  • Sorted or classified information according to guidelines, such as content, purpose, user criteria, or chronological, alphabetical, or numerical order
  • Researched and retrieved information from files in response to requests from authorized users
  • Analyzed incoming materials to determine how and where they should be classified or filed
  • Organized materials into proper locations such as file cabinets, boxes, bins, or drawers according to the classification and identification of information
  • Assigned, recorded or stamped identification numbers or codes to index materials for filing.

Sales Associate

Dicks Sporting Goods
11.2013 - 06.2014
  • Greeted customers and assisted with what they were looking for
  • Provided customers with descriptions, use, operation, and care of different merchandise
  • Made recommendations, selected, and helped locate or obtain merchandise based on customer needs and desires
  • Computed sales prices, total purchases and received and processed cash or credit payments
  • Prepared sales slips or sales contracts
  • Maintained knowledge of current sales and promotions, policies regarding payment and exchanges, and security practices
  • Placed special orders or contacted other stores to find desired items.
  • Organized racks and shelves to maintain store visual appeal, engage customers, and promote specific merchandise.
  • Handled cash transactions efficiently while adhering to company cash handling policies, ensuring accuracy in all financial exchanges.
  • Managed returns, exchanges and refunds in accordance with store policy.
  • Prepared merchandise for sales floor by pricing or tagging.
  • Helped customers locate products and checked store system for merchandise at other sites.
  • Answered customer questions about sizing, accessories, and merchandise care.
  • Rotated stock and restocked shelves to maintain product availability and store appearance.
  • Accurately processed POS transactions, returning coin, currency, payment cards, and receipts to customers.

Operations Assistant Manager

Samuel Adams Grille
10.2012 - 02.2013
  • Responsible for opening and closing the restaurant
  • Computed safe and issued money drawers to bartenders and cashier
  • Counted drawers at end of the night and made deposits
  • Scheduled staff hours and assigned duties
  • Established standards for personnel performance and customer service
  • Inspected food dates in kitchen, made sure all food was stored properly and kitchen was cleaned to restaurant policy standards
  • Assisted with catering events
  • Provided customer satisfaction by speaking with them and seeing if their needs were met.
  • Managed day-to-day department operations with effective workflow coordination.

Reservation Clerk

Safari West Wildlife Preserve
05.2008 - 09.2008
  • Plan routes, itineraries, and accommodation details
  • Compute fares and fees, using schedules, rate books, and computers
  • Prepare customer invoices and accept payment
  • Record guest comments or complaints, referring customers to managers as necessary.
  • Streamlined the reservation process for efficiency, leading to faster response times for clients.
  • Supported front desk operations during peak periods, providing seamless check-in/check-out experiences for hotel guests.
  • Resolved booking conflicts or errors swiftly, minimizing negative impacts on client experiences.
  • Ensured compliance with all company policies regarding payment processing, cancellations, refunds, and reservation changes within established guidelines.
  • Managed a high volume of reservations, maintaining accuracy and organization under pressure.
  • Participated in weekly meetings with management to discuss progress toward occupancy goals as well as any challenges encountered in maintaining optimal reservation levels.
  • Adapted quickly to changing circumstances, such as guest cancellations or last-minute bookings, to maintain a smooth reservation process and high levels of customer satisfaction.

Purchasing and Receiving

Ferrari-carano Vineyards/wine
05.2007 - 02.2008
  • Examine contents and compare with records to verify accuracy of incoming or outgoing shipment
  • Determine shipping method for materials
  • Pack, seal, label, and affix postage to prepare materials for shipping
  • Confer or correspond with establishment representatives to rectify problems
  • Requisition and store shipping materials and supplies
  • Receive and count stock items, and record data manually or using computer
  • Mark stock items using identification tags, stamps, electric marking tools, or other labeling equipment
  • Knowledge of FedEx, UPS shipping computer systems.
  • Pulled, verified, and packaged items for shipment.
  • Managed inventory control with meticulous attention to detail, ensuring accurate stock levels.
  • Prepared shipping documents and invoices, processed payments, and fielded client questions.
  • Created effective communication channels between warehouse staff, management, and customers to address concerns promptly and maintain smooth operations.
  • Conducted counts and audits of inventories to identify and resolve discrepancies in records.
  • Maintained positive relationships with representatives of UPS, FedEX, USPS, and DHL shipping companies.
  • Organized storage areas to optimize materials movements and minimize labor hours.

Education

No Degree - Business Studies

Barstow Community College
Barstow, CA

No Degree - Medical Coding And Billing

Career Step
Online

No Degree - Sports Event And Entertainment

Johnson & Wales University - Denver
Denver, CO

Skills

  • Claims Auditing
  • Customer Communication
  • Claims Processing
  • Microsoft Office
  • Legal Compliance
  • Team Leadership
  • Multitasking and Organization
  • Information Verification
  • Regulatory knowledge
  • Deadline-oriented

Certification

Compliance Certificate Training - MBA

Accomplishments

  • Supervised team of 4 staff members.
  • United States Army—Military ball coordinator; Co-Leader and Treasure for 699th Maintenance Battalion 2011-2013
  • Patriotic Civilian Service Award, 2012

Timeline

CLAIMS ADMINISTRATOR

ACCUSERVE
05.2023 - Current

Loan Level Compliance Supervisor

Premier Mortgage Resources
08.2019 - Current

Estimator

Franklin Building Supply
06.2019 - 08.2019

Purchasing and Receiving

Images Flooring
08.2018 - 05.2019

Pharmacy Technician Denial Specialist

Schryver Medical Group
01.2017 - 08.2018

Event Operations

Epicurian Sports
08.2016 - 11.2016

Pharmacy Technician Lead (SME)

Xerox - CVS Pharmacy
11.2014 - 06.2016

Funder Assistant

Stearns Lending LLC
06.2014 - 08.2014

Sales Associate

Dicks Sporting Goods
11.2013 - 06.2014

Operations Assistant Manager

Samuel Adams Grille
10.2012 - 02.2013

Reservation Clerk

Safari West Wildlife Preserve
05.2008 - 09.2008

Purchasing and Receiving

Ferrari-carano Vineyards/wine
05.2007 - 02.2008

No Degree - Business Studies

Barstow Community College

No Degree - Medical Coding And Billing

Career Step

No Degree - Sports Event And Entertainment

Johnson & Wales University - Denver

Compliance Certificate Training - MBA

Danielle Crawford