Accomplished operations professional with extensive experience in risk management and client relationship management. Demonstrated ability to streamline processes, enhance team performance, and achieve organizational goals through effective training and supervision.
Oversee and manage client relationships, budgets, coordinate vendors, logistics, marketing, and ensure goals are aligned with organizational needs.
Planning and monitor the day to day operation to ensure efficient to external stakeholders for long term operational strategies.
Supervise and train new hires to maintain metrics and standards to measure the company’s overall efficiency and effectiveness to optimize productivity.
Review and process workers compensation claims in accordance with applicable laws, regulations, healthcare management records, and company guidelines.
Negotiate settlement with claimants, employers, and legal representatives balancing the interest of all parties while minimizing the cost and liability for the company.
Provide guidance to adjusters as they go through the onboarding/training process, foster their professional development and enhancing performance.
Monitor the processing of enrollments, claims reimbursement, unemployment claims, and termination for FSA HRA plans.
Manage, train and guide team of benefits administration or specialist to ensure daily tasks are completed accurately and on time.
Compile, analyze, audit, and present statistical data and performance metrics to senior management and external parties.
Assess and Support Individual Needs: Evaluate the needs of individuals, identify barriers to care, and recommend appropriate resources while assisting with daily living activities such as personal care, meal preparation, and mobility support.
Coordinate Care and Access to Resources: Work with healthcare providers, specialists, and community resources to ensure timely access to necessary services, including housing, employment, education, and healthcare/ Medicare insurance.
Monitor Well-being and Provide Education: Track changes in health or condition, document care activities, and educate individuals and caregivers on care plans, procedures, and available healthcare benefits.
Facilitate training programs and professional development activities to stay updated on changes in healthcare compliance, privacy, audit regulation, and investigation management.
Led compliance and privacy audits (ADA, OSHA, EEOC, PHI/PII) and strengthened vendor oversight, reducing organizational risk and ensuring 100% annual Business Associate Agreement compliance. Streamlined policy and records management by developing and revising procedures, facilitating cross-departmental alignment, and ensuring full regulatory compliance.
Investigated and resolved privacy violations, optimized the compliance ticketing system, and improved response times, enhancing organizational accountability and risk mitigation.
American Heart Association’s Heart Saver CPR AED (Active)
Texas Department of Insurance License #2871145 (Valid: Aug 2024 – Aug 2026