Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Jay Aviles

New York

Summary

Dynamic Senior Claims Analyst with proven expertise at Collabera in fraud detection and resolution. Demonstrated critical thinking and problem resolution skills, achieving compliance and enhancing operational efficiency. Proficient in VROL and adept at database management, consistently delivering exceptional customer service and support to teams.

Overview

26
26
years of professional experience

Work History

Senior Claims Analyst

Collabera
Basking Ridge
01.2021 - 01.2024
  • Responsible for handling customer complaints who have contacted the bank through high risk channels
  • Required to solve problems and investigate/resolve a wide variety of issues and requests that include gathering additional information, setting expectations and working with other support organizations to fulfill the request
  • Universal Agent with thorough knowledge of claims function handling complex cases requiring high level analytical and problem resolution skills
  • Processing multiple types of claims, specializing in ACH, MRA, CRSD, CHARGEBACK, CHARGEOFF, ATM, and POS fraud claims by conducting an independent investigation resulting in a declination or pay decision while consistently adhering to production and quality procedures implemented by line of business
  • Determines appropriate resolution using strict adherence to internal guideline, policies, and procedures
  • Navigating and mastering multiple systems such as Visa Resolve On-Line and Visa Prepaid Automation System to resolve customer requests
  • Self-manage with proven ability to provide team support
  • Exhibit sound leadership skills by assisting manager with team of 20 in responding to process/procedural questions and development
  • Provide critical side by side training to agents with feedback to agents’ managers to ensure quality of results found in audit and reconsiderations
  • Audit fraud claims and fraud reconsiderations, ensuring integrity of business procedure on claim resolution
  • Work with regulatory auditor to ensure claim decisions are consistent throughout all audited claims and suggested new processes that were implemented at the chargeback stage to maintain uniformity
  • Ensure all cases are resolved in compliance with industry regulations, bank procedures per specified criteria, integrity levels of the department's case management system, and financial controls
  • Use Lexis Nexis, Innovis and other EWS – Early Warning Services for enhance detection or ruling out 1st Party Fraud
  • Analyze fraud findings to determine extent of fraud risk for possible referral for suspicious activity, Identity Theft, Account Take Over through patterns, anomalies, and trends
  • Accountable for the successful resolution of all customer requests or recognize and bring forth issues that require escalation to senior management

Human Resource Assistant

Morgan State University
Baltimore
01.2019 - 01.2020
  • Respond to inquiries regarding human resources policies, procedures and programs
  • Update, maintain and research data in human resources information systems (MEMS, HireRight, APEX, Banner)
  • Assist employees in completing human resources forms and transactions
  • Processed employee non-payment claims
  • Manage small to intermediate projects
  • Update Job Specifications for MSU website

Administrative Assistant

Kelly Services
Baltimore
01.2019 - 12.2019
  • Manage Tru Vantage customer database daily
  • Reviewed inter-company accounts
  • Processed 100+ invoices monthly pertaining to inventory, checking for accuracy
  • Process purchase orders, comparing against invoice statements
  • Assure DOT records are maintained and in compliance with state law
  • Prepared spreadsheet and journal entries daily
  • Assisted with month end closing
  • Process payments through Verifone Payware Connect
  • Some Quickbook knowledge

Legal Assistant

Dreyfus Corporation
New York
01.2011 - 01.2013
  • Calculated Dreyfus Funds and Edgar Unit personnel time for the purpose of billing individual funds
  • Prepared and coordinated quarterly board meetings
  • Produced documents requested by board members in regard to group funds
  • Processed invoices for reimbursement services on behalf of the Dreyfus Funds
  • Requested and distributed reimbursement checks for board members expenses
  • Generated attorney expense reports using PeopleSoft Financials
  • Managed Dreyfus Funds auditors request insuring audit ran smoothly

Legal Coordinator

New York Stock Exchange
New York
01.2009 - 01.2011
  • Provided executive-level administrative support to VPs and Associate General Counsels
  • Prepared and submitted approximately 20 rule filings per month to be submitted to the U.S
  • Securities and Exchange Commission (SEC)
  • Filed Amex quarterly reports to Federal Election Committee accounting for hundreds of thousands of dollars donated to politicians
  • Supported Code of Conduct Program to assure employees were in compliance with federal laws
  • Effectively reducing non-compliance by 15%
  • Trusted to properly shut down the Amex Legal Department after the acquisition by the New York Stock Exchange assuring proper transfer of all required documents

Administrative Proceedings Assistant

U.S. Securities & Exchange Commission
New York
01.1998 - 01.2003
  • Managed daily reporting service needs of the SEC’s Northeast Regional Office
  • Acted as sole liaison between the reporting companies and the SEC attorneys
  • Scheduled requests for reporter services needed to take testimonies and depositions
  • Proofread official testimony transcripts taken from investigative and administrative proceedings
  • Coordinated administrative proceedings, greeted administrative law judges, and assigned hearing rooms

Education

Completed 2 years -

Empire State College
Brooklyn, NY

Certificate - Travel with Honors

International Aviation and Travel Academy
Arlington, TX

Skills

  • Claims Analyst
  • VROL
  • Record Maintenance
  • SME in Prepaid Fraud
  • Visa PAS
  • Department Reports
  • Problem Resolution
  • Database Management
  • Employee Relations
  • Critical Thinking
  • Client Billing
  • Office Coordination
  • Effective verbal/written communication
  • Proficient in MS Office Suite
  • Customer Service

Accomplishments

  • Serve on the Advisory Board at Aspire Wellness Center, Not Provided, Nottingham, MD
  • Served as Chairwoman of Trustee Board at Mt. Joy Baptist Church, Not Provided, Brooklyn, NY
  • Successfully transitioned legal department of the American Stock Exchange (AMEX) during merge with the New York Stock Exchange (NYSE), Not Provided
  • Promoted from Office Automation Clerk to Administrative Proceedings Assistant at U.S. Securities and Exchange Commission (SEC), Not Provided
  • Successfully planned corporate events for 25-200 people with a limited budget and minimum resources, Not Provided

Timeline

Senior Claims Analyst

Collabera
01.2021 - 01.2024

Human Resource Assistant

Morgan State University
01.2019 - 01.2020

Administrative Assistant

Kelly Services
01.2019 - 12.2019

Legal Assistant

Dreyfus Corporation
01.2011 - 01.2013

Legal Coordinator

New York Stock Exchange
01.2009 - 01.2011

Administrative Proceedings Assistant

U.S. Securities & Exchange Commission
01.1998 - 01.2003

Completed 2 years -

Empire State College

Certificate - Travel with Honors

International Aviation and Travel Academy

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Jay Aviles