Liliana Callejas
NJ
Summary
Detail-oriented professional with extensive experience in data quality analysis and compliance coordination. Known for effective problem-solving and cross-functional collaboration, contributing to the resolution of policy reporting errors and ensuring adherence to regulatory standards.
Overview
11
11
years of professional experience
Work History
Data Quality Analyst, Carrier Testing
NJ Compensation Rating & Inspection Bureau
Newark, NJ
02.2023 - Current
- Participate in requirements gathering sessions with insurance carriers to understand needs related to Data Quality for Test file submissions.
- Evaluate policy testing information using WCPOLS reporting requirements to determine test data submissions are correct.
- Correspond with data providers and internal staff to communicate and resolve policy reporting errors.
- Participate in industry meetings, workgroups or conferences as needed.
Payment & Forms Claim Tech
Liberty Mutual Insurance Company
12.2017 - 12.2019
- Calculated Workers' Compensation benefits for nine distinct jurisdictions and issued weekly, biweekly, or monthly wages to claimant or beneficiaries.
- Adhered to strict deadlines by submitting all necessary electronic and paper forms promptly, avoiding state fines and penalties.
- Calculated and issued settlement checks to claimants, beneficiaries, and third party providers.
- Filed Bi-Monthly and Quarterly reports outlining all transactions made on claims.
- Collaborated with Case Managers and other internal departments as needed.
- Audited open Workers' Compensation claims to calculate and issue rate adjustment checks as needed.
Compliance Coordinator
BioReference Laboratories
12.2014 - 12.2017
- Conducted compliance trainings and issued regular memos detailing compliant work practices to promote employee awareness of company policies.
- Analyzed data to provide insights and recommendations for mitigating conduct risk.
- Planned and executed compliance audits of existing company policies, procedures and controls.
- Performed incident investigations.
- Reviewed sales team expenses to ensure all expenditures were compliant with sales reimbursement policies.
- Maintained and reviewed internal and third party contracts and Business Associate Agreements to ensure compliance with federal and state regulations.
- Attended biweekly compliance meetings to discuss policy implementation and risk minimization.
Education
Associate of Arts - Business Administration
University of Phoenix-Online Campus
05.2010
Skills
- Audit Procedures
- Relationship Building
- Billing Dispute Resolution
- Investigative Research
- Proficient with phone systems and order entry systems
- Conflict Resolution
- Records Management
- Documentation and Reporting
- Verbal and Written Communication
- Regulatory Compliance
- Problem-Solving
- Cross-Functional Collaboration
- Customer Service KPI Metrics (CSAT, CES, NPS)
- Performed Quality Assurance reviews
- Organization and Multitasking
- Senior level Customer Service Experience
- Team Lead Experience
Timeline
Data Quality Analyst, Carrier Testing
NJ Compensation Rating & Inspection Bureau
02.2023 - Current
Payment & Forms Claim Tech
Liberty Mutual Insurance Company
12.2017 - 12.2019
Compliance Coordinator
BioReference Laboratories
12.2014 - 12.2017
Associate of Arts - Business Administration
University of Phoenix-Online Campus