Renee Pryor

Reviewed high‑cost medical claims, identified discrepancies, and ensured compliance with stop‑loss policy terms to mitigate financial risk. Collaborated with carriers, TPAs, and internal teams to ensure seamless communication and efficient audit processes. Ensured accuracy and confidentiality in audits, delivering high‑quality results within established timelines. Seeking opportunities to contribute expertise within healthcare, insurance, or claims operations

• Evaluated transaction records, reconciliations, and supporting documentation for accuracy and policy adherence.
• Led risk-based audits across financial and operational processes, strengthening internal control effectiveness.
• Evaluated SOX controls and documented deficiencies, supporting timely remediation efforts.
• Reviewed financial statements and supporting schedules for compliance with GAAP and corporate policies.

• Supported processors in achieving National Division goals through collaboration and guidance.
• Enhanced operations by collaborating with team members and customers to identify and implement effective solutions.
• Demonstrated self-reliance by meeting and exceeding workflow needs.
• Oversaw daily inventory management to ensure accurate stock levels. and tracking and working with team on resolution
• Conducted and coordinated with other units on procedural problems involving complex cases.
• Worked with processors on validating audit errors given by auditors.

• Reviewed project requirements, created test scenarios, and tested legacy system to ensure successful transition to the new system.
• Collaborated with off-site teams to execute tests on schedule and facilitate seamless product releases.
• Documented defects and supported developers in testing and resolving issues to enhance software quality.
• Completed unit and regression tests on software and individual modules
• Demonstrated initiative in managing tasks independently to meet workflow needs.