Tanice Lawrence-Tinubu
Tampa,Fl
Summary
Proficient in current health insurance specific in Medicare regulations, standards and best practices. Analytical and detail-oriented professional focused on making sure products meet all relevant regulatory requirements. Methodical and objective with good judgment and sound critical thinking and problem-solving abilities.
Overview
9
9
years of professional experience
Work History
Sr Compliance Regulatory Analyst
HealthPlan One
10.2019 - 10.2023
- Minimize risk by providing data analytics to support business as necessary
- Primary liaison for external and internal compliance methods and escalations
- Subject matter expert on compliance procedures
- Influenced positive change within the organization by identifying process improvements aimed at increasing efficiency without compromising compliance standards.
- Conducted regular audits of internal processes to verify compliance with established policies and regulations.
- Audit and monitor compliance trending opportunities and report key findings
- Liaison between the carrier and internal business unit on remediating risk and gaps
- Create and execute training for associates, and wrote step action processes on system and compliance procedures
- Provide internal support for the business unit to mitigate compliance risk
- Work closely with management to provide strategic guidance and oversight in data retrieval and archive initiatives
- Implement applicable corrective actions plan to correct deficiencies set forth by state and federal guidelines.
Quality Assurance Analyst/Process Risk Champion
Wipro
09.2016 - 10.2019
- Monitor calls for quality assurance purposes and audit representatives according to quality standards
- Handling highly confidential information and complying with HIPPA, and PHI regulations
- Participated in regular meetings with cross-functional teams to discuss progress updates, communicate concerns or challenges, and ensure alignment of project goals.
- Demonstrated strong analytical and problem-solving skills to complete daily tasks
- Mentored and coached team members on QA topics and strategies.
Quality Assurance Analyst/ Billing Processing Auditor
Wipro
05.2014 - 09.2016
- Audit billing processors to ensure accuracy and improve quality performance by 95%
- Research and analyze the appropriate documents for audit processes
- Explore past and present billing for accurate adjustments
- Coach processors that score below the quality standards to promote quality performance
- Review underwriting applications for data entry accuracy and premium amounts
- Communicate with quality management leadership team regarding group or individual training based on audits
- Allocate data from red critical performance measures for weekly reports
- Research policies and procedures on carriers
- Conduct meetings with the business unit to calibrate on quality standards
- Developed new process for employee evaluation, which resulted in marked performance improvements.
Customer Service Associate
HealthPlan Services
05.2014 - 10.2015
- Assisted clients with product selection and demographic deficiencies
- Utilize active listening and problem-solving skills
- Assisted with billing inquiries, client enrollment/documents, and product termination
- Investigated and corrected errors upon customers' request, according to records
- Transfer calls to the appropriate department for further assistance
- Subject Matter Expert for new associates
- Meet and/or exceed productivity quotas, quality standards, and performance goals
- Provide training and support to the New Hire
- Assist members with premium billing payments
- Exhibited exceptional customer service at all times, including addressing customer inquiries and ensuring resolution.
Customer Service Associate
HealthPlan Services
05.2014 - 10.2015
- Assisted clients with product selection and demographic deficiencies
- Utilize active listening and problem-solving skills
- Assisted with billing inquiries, client enrollment/documents, and product termination
- Investigated and corrected errors upon customers' request, according to records
- Transfer calls to the appropriate department for further assistance
- Subject Matter Expert for new associates
- Meet and/or exceed productivity quotas, quality standards, and performance goals
- Provide training and support to the New Hire
- Assist members with premium billing payments
- Exhibited exceptional customer service at all times, including addressing customer inquiries and ensuring resolution.
Customer Service Associate
HealthPlan Services
05.2014 - 10.2015
- Assisted clients with product selection and demographic deficiencies
- Utilize active listening and problem-solving skills
- Assisted with billing inquiries, client enrollment/documents, and product termination
- Investigated and corrected errors upon customers' request, according to records
- Transfer calls to the appropriate department for further assistance
- Subject Matter Expert for new associates
- Meet and/or exceed productivity quotas, quality standards, and performance goals
- Provide training and support to the New Hire
- Assist members with premium billing payments
- Exhibited exceptional customer service at all times, including addressing customer inquiries and ensuring resolution.
Quality Assurance Analyst/Process Risk Champion
Wipro
05.2014 - 10.2019
- Performs multifaceted administrative duties to support upper management, team, and staff; such as composing and preparing complex correspondence and other specialized assignments
- Communicate effectively both oral and written
- Communicate compelling information that is beneficial to both management and staff about the quality performance
- Create documents, including organization charts, Excel spreadsheets, and PowerPoint presentations
- Create standard operational procedures for quality assurance purposes
- Support management by researching and allocating information for meetings
- Schedule and lead high prioritized meetings
- Execute functions for Business Planning Analyst with journal entries
- Ability to manage multiple projects by prioritizing time effectively
- Researched and updated all required materials needed for firm and partners.
Education
BBA - Business Administration
Strayer University
Washington, DCAssociate of Arts - Allied Health
Hillsborough Community College
Tampa, FLSkills
- Team leadership
- Leadership liaison
- Self-motivated
- Risk management processes and analysis
- Conflict resolution
- Client assessment and analysis
- Report writing
- Data analysis
- Extremely organized
- Interpersonal and written communication
- Data management
- Process implementation
- User interface understanding
- Legal Research
Timeline
Sr Compliance Regulatory Analyst
HealthPlan One
10.2019 - 10.2023
Quality Assurance Analyst/Process Risk Champion
Wipro
09.2016 - 10.2019
Quality Assurance Analyst/ Billing Processing Auditor
Wipro
05.2014 - 09.2016
Quality Assurance Analyst/Process Risk Champion
Wipro
05.2014 - 10.2019
Customer Service Associate
HealthPlan Services
05.2014 - 10.2015
Customer Service Associate
HealthPlan Services
05.2014 - 10.2015
Customer Service Associate
HealthPlan Services
05.2014 - 10.2015
BBA - Business Administration
Strayer University
Associate of Arts - Allied Health
Hillsborough Community College
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