Elaine Sanders
Justin,TX
Summary
Seasoned Financial Services, Banking, and Insurance Professional with proven ability to adapt to changing environments. Proven background in Financial Services, Quality Control/Assurance, and Customer Relationship Management. Possessing over 20 years of customer service experience, and the ability to learn quickly and efficiently become a subject matter expert in any position. Exceptionally detailed, organized, and highly accurate possessing a unique ability to successfully manage multiple priorities simultaneously. Solid skills in organizing, planning, ensuring quality and accuracy, and paying close attention to pertinent details. Organized and detail-oriented. Investigator dedicated to improving efficiency, productivity, and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.
Overview
12
12
years of professional experience
Work History
Chart Retrieval Specialist
Episource
08.2023 - Current
- Executing Medical Record retrieval from various healthcare facilities on behalf of health plans and other clients for retrospective and prospective Medical Risk Adjustment Reviews
- Ensuring Compliance with HIPAA guidelines while ensuring the confidentiality of PHI
- Entrusted to act as a role of authority, making yourself approachable and willing to help other team members with their inquiries
- Executing document imaging and scanning and demonstrated proficiency with numerous Electronic Medical Record (EMR) systems
- Proven ability to work independently while collaborating with medical office staff, fellow Episource Chart Retrieval Specialists, and leadership
- Using Salesforce CRM Tool to manage and track office appointments
- Tracking and submitting Travel and Expenditures via QuickBooks Expense Management System.
- Documented all investigation activity and presented reports to management.
- Verified insurance claims and determined fair amount for settlement.
- Researched and analyzed policy contracts to verify proper payment of claims.
Document Reviewer
Hirenomics
10.2022 - 06.2023
- Executing legal document review regarding litigant claims on class action lawsuits
- Reviewing and responding to inquiries from litigants via multiple communication channels
- Exemplifying clear and concise verbal and written communication
- Experience in Privilege review/screen, Issue Tags, Keywords/Coding, First and Second pass reviews
- Proven ability to work under tight deadlines and SLA’S
- Executing research and multi-tasking to handle multiple workflow assignments with regard to the cases that are pending resolution
- Acting as a liaison to partner closely with our internal partners and leadership to ensure a timely and accurate experience
- Cultivated productive relationships with stakeholders, facilitating claims lifecycle
- Examined claims forms and other records to determine if claims are payable
- Prepared summaries of damage, amount payable
Mortgage Consultant, Compliance
Guaranteed Rate Inc.
09.2020 - 07.2022
- Audit and assemble all required information and documentation from other departments; scrub and analyze loan files
- Maintain a knowledge of current State, Federal and Company Policies and requirements regarding HMDA, ECOA and other Compliance Regulations and updates Compliance policy and procedures as needed
- Reviewed all government regulations for homeowners insurance policies
- Interpreting policy language and liability evaluation to ensure adequate coverage for the mortgaged property
- Analyzed loan applications and credit reports to determine loan eligibility and risk level.
- Review new contracts/applications/agreements to ensure all necessary clauses have been included and executed accordingly
- Executing review and reconciliation of Invoices for Appraisals, Credit Vendors, and Insurance Agencies relevant to the loan application
- Acting as a liaison to partner develop and maintain close working relationships with Sales/Loan Officers and our internal business partners to ensure a timely and accurate experience
- Provides excellent customer service by effectively communicating and cooperating with all internal and external customers
- Evaluated debt ratio, loan-to-value ratios, credit scores, property valuations and various other factors when making underwriting eligibility decisions
Sr. BPO Specialist, Quality Analyst
NTT Data
02.2020 - 09.2020
- Reviewing and approving purchase orders, and Executive Corporate Travel and Expenditures via Concur for travel expenditures of project staff
- Analyzing escalations regarding basic identity information following standard Know Your Customer (KYC) procedures from approved internal and external data sources
- Analyzing and reviewing account ownership for complex business entities, trusts, and individuals
- Analyzing customer transactional activity (e.g Money movement etc.) and behavioral patterns to identify potential suspicious activity
- Conduct, review, and evaluate findings using AML/KYC/CIP knowledge
- Exemplifying knowledge of a multitude of financial products including Investment Accounts, Mortgages, Demand Deposit Accounts, Auto, Credit Card Accounts, Personal Loans, and HELOCs.
Quality Analyst, Risk Compliance Audit
US Bank
05.2016 - 11.2019
- Quality/Audit review of loans within the Mortgage Servicing that quality issues are proactively identified
- Escalating performance measures and quality improvements for management review and cross-trained in Mortgage Underwriting and flood
- Enterprise Risk Management liaison, responsible for ensuring the bank is aligned with industry standards, company requirements, and are compliant
- Analyzing Borrower Contractual Documents for accuracy
- Serves as a functional liaison between the Line of Business and the Lines of Defense
- Create, implement, maintain, review or oversee an effective risk management framework for Flood insurance, PMI, Escrow, FHA, Conventional, and Freddie, Underwriting
- Interpreting policy language and liability evaluation to ensure adequate coverage for the mortgaged property
- Prepared summaries of, payments, and required flood insurance policy coverage
- Managed the research of existing operations, procedures, workflow, requirements, and implementation of new regulatory initiatives that impact compliance with regulatory governance
- Researched and analyzed policy contracts to verify proper payment of policy premiums
- Default Underwriting Special Project - Performing credit analysis, and income calculations for fixed income, self-employment (P &L Analysis), wage earners, and verification of HMD
Substitute Teacher
Kelly Education
01.2016 - 05.2016
- Curriculum Development, and lesson planning
- Classroom instruction of K-12 students, trade, and adult education as well
- Assessment/Evaluation of student progress
- Classroom and behavior management
- Assisting administrative staff with conflict/resolution.
Customer Service Professional, Life Health Response Center
State Farm Insurance
12.2015 - 01.2016
- Providing world class service and guidance to State Farm Agents, and policy holders
- Performing accounting research of premium payments, dividends, loan payments, and customer refunds
- Advising agents of outstanding requirements for timely issue of new policies, and change of plan coverage on existing policies
- Assessing details and submitting initial review for death claims and providing updates to beneficiaries
- Surpassed performance goals by approaching interactions with resourcefulness, organization and customer-centric solutions.
Quality Control Analyst, MB Financial Ops Specialist
JP Morgan Chase
06.2015 - 12.2015
- Performing accounting, and reconciliation of default claims Mortgage Loss Mitigation and Bankruptcy accounts to minimize overall bank loss
- Collecting supporting documentation, researching ledger transactions, and accurately entering data into appropriate systems
- Claim investigation to determine proper proceeds that should be submitted to the Investors
- Maintaining supporting documentation in organized account review files for loss mitigation options and bankruptcy accounts
- Assisting leadership with creation of training materials
- Analyzing Modification Agreements, Repayment Plan Agreements, and BK POC’s, MFR’s to ensure that contractual terms for repayment align with regulatory requirements
- Utilizing quality review guidelines to investigate, resolve, and respond to errors
- Clearly documenting QC Review steps in ensuring compliance with internal and external policies and procedures
- Trained and coached existing and new employees on multiple investigative case types and internal control processes.
Operations Project Manager
Bank of America
02.2012 - 12.2014
- Managed the research and governance of existing operations, procedures, salesforce CRM system and operational workflow, product and service requirements and implementation of new regulatory initiatives that impact compliance
- Executing review of laws and regulations for business impact and borrower correspondence to ensure compliance with regulatory and legal requirements and enterprise policy
- Provided program management support to 75 production associates across multiple lines of business within the organization
- Executing both internal control examinations and providing data for external control examinations as well as providing strategic and proactive consultation in identifying risk exposures and developing solutions for weaknesses and regulatory compliance issues
- Leading and planning remediations and providing support to business partners and senior leadership by monitoring action plans to ensure root cause of control deficiencies are resolved in a timely manner
- Managing and processing payroll and ensuring that the appropriate cost center codes were utilized for the business client
- Successfully partnered with Sr
- Leadership and Production Business Partners to develop and transition plans, including ongoing success measures and milestones, to sustain newly implemented change initiatives for Program Management to enhance the overall Portfolio
- Reviewing and approving purchase orders, and Executive Corporate Travel and Expenditures via Concur
- Analyzing and managing ownership and governance approval for changes to contractual and borrower correspondence documents
- Exemplifying working knowledge of AML/Financial Crime red flags, risks, investigation processes and reporting requirements.
Education
Some College - previously pursuing Bachelors of Business Administration with a Major in Management -
Eastern Michigan University
Ypsilanti, MI01.2007
Skills
- Customer Relationship Management
- Quality Control Audit
- Claims Processing
- AML
- Insurance
- Confident and poised in interactions with individuals at all levels
- Contract Analysis
- Salesforce
- PeopleSoft
- Program Management
- Working in fast-paced environments demanding strong technical and interpersonal skills
- Detail-oriented
- Analytical ability
- Individual experienced in prioritization and delegation of tasks effectively to ensure timely project completion within a team environment
- Quality Management
- Account Management
- Oracle and SAP
- Insurance Policy Coverage Knowledge
- Policy Investigations
- Risk Management
Timeline
Chart Retrieval Specialist
Episource
08.2023 - Current
Document Reviewer
Hirenomics
10.2022 - 06.2023
Mortgage Consultant, Compliance
Guaranteed Rate Inc.
09.2020 - 07.2022
Sr. BPO Specialist, Quality Analyst
NTT Data
02.2020 - 09.2020
Quality Analyst, Risk Compliance Audit
US Bank
05.2016 - 11.2019
Substitute Teacher
Kelly Education
01.2016 - 05.2016
Customer Service Professional, Life Health Response Center
State Farm Insurance
12.2015 - 01.2016
Quality Control Analyst, MB Financial Ops Specialist
JP Morgan Chase
06.2015 - 12.2015
Operations Project Manager
Bank of America
02.2012 - 12.2014
Some College - previously pursuing Bachelors of Business Administration with a Major in Management -
Eastern Michigan University
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