Sergio Fernandez
Apple Valley,Minnesota
Summary
Experienced Risk and Compliance Analyst with a strong background in insurance fraud, risk assessment, and compliance within financial and healthcare sectors. Proven track record in managing confidential data, performing complex investigations, and collaborating with cross-functional teams to drive risk mitigation strategies and ensure compliance. Known for analytical skills, attention to detail, and a proactive approach to risk management.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Investigator
Minnesota Attorney General Office
09.2023 - Current
- Conduct complex investigations to support fraud prevention and compliance efforts.
- Draft legal documents such as search warrants and subpoenas to enforce regulatory standards.
- Collaborate with law enforcement and internal stakeholders to implement risk management procedures and safeguard public resources.
- Analyze data for trend identification, prioritizing investigative resources and initiatives for optimal impact.
Fraud Analyst 4
US Bank NA
06.2021 - 09.2023
- Analyzed customer transactions to detect and prevent fraudulent activities, supporting compliance with anti-fraud regulations.
- Partnered with legal, compliance, operations, and technology teams to enhance risk detection and prevention through data analysis.
- Managed and reviewed high volumes of flagged transactions, utilizing data insights to improve early risk detection.
- Conducted detailed assessments to ensure adherence to regulatory requirements.
Customer Care Advocate
Blue Cross and Blue Shield of Minnesota
04.2017 - 06.2021
- Provided comprehensive guidance on insurance products, policies, and claims, enhancing client understanding of coverage and limitations.
- Investigated billing and coding discrepancies to improve accuracy and compliance with healthcare regulations.
- Ensured confidentiality of sensitive patient information in alignment with HIPAA standards and best practices in data privacy.
Education
Bachelor of Science - Management Information Systems
Metropolitan State University
Saint Paul, MN12.2023
Associate of Science - Business
Normandale Community College
Minneapolis, MN05.2019
Skills
Risk Analysis & Mitigation
- Insurance Program Management
- Contract & Compliance Review
- Data Metrics & Reporting
- Cross-functional Team Collaboration
- Confidential Data Handling
- Process Improvement
- Health Information Systems
- Medical Terminology Proficiency
- Excel
Certification
- AML Fintech Compliance Associate
- 2019 - SAP Product Portfolio Award
- 2022 - US Bank Python Bootcamp - 2022
Languages
Spanish
Native or Bilingual
Timeline
Investigator
Minnesota Attorney General Office
09.2023 - Current
Fraud Analyst 4
US Bank NA
06.2021 - 09.2023
Customer Care Advocate
Blue Cross and Blue Shield of Minnesota
04.2017 - 06.2021
Bachelor of Science - Management Information Systems
Metropolitan State University
Associate of Science - Business
Normandale Community College
- AML Fintech Compliance Associate
- 2019 - SAP Product Portfolio Award
- 2022 - US Bank Python Bootcamp - 2022
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