Joanna De Ninis, ARM
Fountain Hills,AZ
Summary
Enterprise Risk Manager - Dynamic, proactive and decisive risk leader who promotes a safe risk-aware culture with unwavering authenticity, integrity and trust. A change agent who adapts well to organizational changes and utilizes effective communication skills to train people as a team player and support guide across all areas of a company. A project manager who seeks ways to minimize the downside of risk and uses analytical skills to optimize the upside of risk to gain a competitive business advantage.
Compliance & Process Specialist - A specialist who plays a vital role in identifying and mitigating compliance risks. Designs and executes compliance and risk mitigation strategies, change management improvements and avoids substantial financial loss and reputation risk.
Workers' Compensation Claims Examiner & Advocate - Claims professional offering expertise in investigation, litigation and settlements to minimize loss exposure for the life of a claim until resolution or closure.
Overview
13
13
years of professional experience
Work History
Enterprise Risk Manager
Self Employed Services
Fountain Hills, AZ
07.2023 - Current
- Conduct risk analyses to manage organizational risk profile, form reliable control systems and monitor legal issues.
- Identify, assess and mitigate potential risks within risk appetite and tolerance to achieve business objectives and to develop and monitor key performance indicators (KPIs) to manage Business Continuity.
- Define key risk indicators (KRIs) to proactively monitor risk dynamics and respond in a timely and effective manner by deploying risk mitigation and incident management plans, processes and procedures.
- Build and cultivate a risk-aware culture through training, exercises and activities for divisions and departments enterprise wide.
- Monitor and analyze risks within the company and report the risk management status and improvement needed to executives/management.
- Review and investigate major incidents, high-risk events and major findings raised from internal and external checks for each division or department enterprise wide. Monitor the effectiveness of action plans.
Caregiver for Mom
Self Employed Services
Fountain Hills, AZ
09.2019 - Current
- Support bathing, dressing and personal care needs.
- Maintain clean and well-organized environment for happiness and safety.
- Observe for changes in physical, emotional, mental or behavioral condition and injuries.
- Monitor vital signs and medication use, documenting variances and concerning responses.
- Contact medical providers to follow up on appointments.
- Partner with registered nurses and physiotherapists to provide care.
Patient Access Scheduling Specialist - Remote
American Vision Partners
Tempe, Arizona
11.2022 - 07.2023
- Scheduled patient appointments and cultivated partnerships with managed care organizations, hospitals and insurance carriers.
- Used NextGen to document calls and schedule appointments.
- Provided exceptional customer service through effective telephone communication.
- Created and maintained accurate and complete records of all customer interactions in job-related software.
Work Comp Claims Advocate - Hybrid
Lovitt & Touche a Marsh McLennan Agency
Tempe, Arizona
01.2019 - 07.2022
- Reviewed documentation of assigned accounts to gain full picture in order to mitigate future risk.
- Pro-actively monitored complex claims for client accounts to assess claim exposure.
- Provided information to clients that allowed them to make the best financial, legal, and ethical decisions for their Workers’ Compensation claims.
- Organized information by using spreadsheets, databases or word processing applications to present claim information to clients.
- Reviewed claim reserves for potential unit stat reserve reductions for the benefit of client’s Experience Modification Rating.
- Negotiated settlement of claims with insured, insurer and attorney.
- Conducted Workers’ Compensation 101 and Best Practices training for clients to encourage processes that will reduce future risk.
- Improved processes and workflows as member of the Recognition and Communication Committees.
Work Comp Claims Resolution Manager
The Best IRS - Insurance Recruiting Specialists
Phoenix, AZ
08.2018 - 11.2018
- Administered indemnity claims for various Arizona clients on behalf of well-known Third-Party Administrator.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Resolved customer inquiries and complaints requiring management-level escalation.
Work Comp Claims Representative I & II
CCMSI
Scottsdale, AZ
09.2015 - 05.2018
- Provided quality customer service to insured, client and claimants throughout claims process to deliver timely service.
- Managed Workers’ Compensation lost time litigated and non-litigated claims for a national Fortune 500 company with multi-jurisdictional claims handling to include New York, Texas, Georgia, Indiana, Maryland, and Texas Non-Subscriber Plan.
- Investigated and administered claims, as in prior position, per Workers’ Compensation State statutes, guidelines, and filed applicable state forms to bring claims toward resolution and closure.
- Effectively communicated with client representatives, claimants, and attorneys to negotiate final settlements.
- Oversaw & trained claim associates with administrative assistant tasks.
- Improved workflow efficiency as member of the Process Improvement Team.
Work Comp Medical Only Claim Representative
CCMSI
Scottsdale, AZ
01.2014 - 09.2015
- Processed high volumes of medical only claims for various jurisdictions efficiently while working in fast-paced environment.
- Managed medical only Workers’ Compensation claims for Fortune 500 company in 10 different States with exceptional attention to detail by investigating claims, determining compensability, setting reserves, authorizing and paying for applicable medical treatment per doctor directive in accordance with Client Handling Instructions and Corporate Claims Best Practices to move claims for resolution and closure.
- Conducted thorough investigations, provided exceptional customer service, utilized effective communication and listening skills, and maintained effective working relationships with claimant, client, providers, and attorneys.
- Performed all work with integrity while upholding company’s core values and principles.
- Improved processes as team player in a dynamic and changing environment with focus and multi-tasking abilities.
Work Comp Claim Associate
CCMSI
Scottsdale, AZ
10.2011 - 01.2014
- Verified claim data correctness in preparation for processing.
- Clerical duties included office mail processing and identifying new claims for set up and activation.
- Requested bills and records from providers, answered bill status questions, processed bill reconsiderations, and filed required State forms per Adjuster’s directives.
- Summarized and attached medical documents and relayed authorization requests to adjusters.
- Filed and served records to defense counsel and prepared medical records for independent medical evaluations, second opinions, Medicare Set-Asides and Medical Cost Projections.
- Created updated workflows to improve office processes.
Customer Care Professional - Remote
Sykes formerly Alpine Access
Denver, CO
12.2010 - 12.2011
- Interacted with customers to provide and process information in response to inquiries, concerns and requests about services and products.
- Provided customer service in fast-paced call center environment for an insurance industry client.
Education
Bachelor of Science - Accounting
SUNY At Binghamton
Binghamton, NYComputer Programming, Specific Applications
Maricopa Community Colleges - Mesa Community College
Mesa, AZSkills
- Enterprise Risk Management
- Governance, Risk Management & Compliance
- Cyber Risk Management
- Organizational Leadership and Strategic Planning
- Root Cause Risk Analysis
- Monitoring KRIs and KPIs for Business Continuity
- Data Analysis
- Risk Financing/Insurance
Languages
Italian
Professional
Spanish
Limited
Accomplishments
- Licensed Workers' Compensation Adjuster in Arizona and New York.
- Oversaw construction of second home in Overgaard, Arizona.
- Completed Life Coaching Program at Southwestern Institute of Healing Arts.
- Received Associate in Risk Management (ARM) Certification.
- Received CPSS Ophthalmology Certification.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
There is no such thing as perfection, but there is such a thing as balance.
Joanna De Ninis
Timeline
Enterprise Risk Manager
Self Employed Services
07.2023 - Current
Patient Access Scheduling Specialist - Remote
American Vision Partners
11.2022 - 07.2023
Caregiver for Mom
Self Employed Services
09.2019 - Current
Work Comp Claims Advocate - Hybrid
Lovitt & Touche a Marsh McLennan Agency
01.2019 - 07.2022
Work Comp Claims Resolution Manager
The Best IRS - Insurance Recruiting Specialists
08.2018 - 11.2018
Work Comp Claims Representative I & II
CCMSI
09.2015 - 05.2018
Work Comp Medical Only Claim Representative
CCMSI
01.2014 - 09.2015
Work Comp Claim Associate
CCMSI
10.2011 - 01.2014
Customer Care Professional - Remote
Sykes formerly Alpine Access
12.2010 - 12.2011
Bachelor of Science - Accounting
SUNY At Binghamton
Computer Programming, Specific Applications
Maricopa Community Colleges - Mesa Community College
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