Timothy Fuller
Upland,CA
Summary
Experienced Fraud Ops Specialist with over 5 years of expertise in investigating suspicious activity. Committed to finding answers and collaborating with clients and interdepartmental personnel. Demonstrates exemplary skills in project management, analytics, and fraud pattern detection. Highly organized and reliable, builds strong relationships with management and colleagues.
Overview
9
9
years of professional experience
Work History
Fraud Production Specialist
DoorDash
03.2022 - Current
- Collaborated with cross-functional teams to identify potential fraud risks and implement preventive measures.
- Have aided in multiple training classes, including both Dx Pod Onboarding classes and DD Partner training.
- Subject Matter Expert for referral fraud deliveries. Developed a new workflow and knowledge base for referral processes that multiple teams use daily.
- Utilized advanced analytical tools such as Mode, Salesforce, Sigma, and Automatic Deactivated Tool to gain a better understanding of daily fraud types, which resulted in more accurate identification of fraudulent activities.
- Evaluated the effectiveness of current fraud prevention tools, recommending improvements based on industry best practices.
- Tracked fraud cases and monitored trends to develop strategies for prevention.
- Produced detailed reports of fraud investigations and presented findings to senior management.
- Collaborated with team members to discuss fraud trends and brainstorm methods to combat this type of crime.
- Completed multiple case studies on generic cancellations red cards for S&OC
Accounts Receivable Analyst
HAPPY MONEY
04.2019 - 08.2020
- Scheduled and accepted payments, processing members' requests related to loan servicing
- Administered hardship assistance via Deferments, Payment Processing, Skip-A-Payment, and Loan Remodification
- Assisted members with re-amortizing credit union loans to resolve credit card debt
- Set up and sent out new DocuSign based contracts for signing, to apply modified terms
- Addressed Zendesk tickets, inbound calls and chat on members' loan status, towards curing any delinquency
- Worked with members to modify loans through extending the terms of the loan, lowering monthly payments
- Used income calculator to determine best payment terms with member in financial hardship per COVID-19 relief.
- Handled sensitive client information with discretion, ensuring confidentiality at all times.
- Delivered outstanding customer service by maintaining a professional demeanor during high-pressure situations.
- Reduced collection time for outstanding invoices by closely monitoring aged accounts and maintaining frequent communication with clients.
- Participated in the month-end close process, ensuring accurate reporting of accounts receivable balances and timely submission of data for financial statements.
Benefits Administrator
CALIFORNIA CHOICE ADMINISTRATORS
10.2018 - 03.2019
- Addressed employer questions on new hires, billing/discrepancies, open enrolment supply or urgent enrollments
- Liaised between employers and COBRA third-party Administrators
- Contacted Anthem Blue Cross, Sharp Health, Sutter Health Plus, Kaiser, and Oscar for employees and employers
- Reached out to Ameritas, Smilesaver, VSP, and Eyemed to verify ancillary benefits
- Reviewed changes annually to group plans' benefits, participating health care service plans, ancillary benefits, and program features
- Educated employers and employees/dependents regarding PCP's, ID cards, RX problems, administrative procedures, dependent coverage, and address changes.
- Ensured timely processing of life event changes, diligently updating employee records as needed.
- Maintained strict confidentiality when handling sensitive employee information related to benefit plans and personal circumstances.
Specialist, Insurance Collections
PACIFIC DENTAL SERVICES (NATIONAL SUPPORT CENTER)
01.2017 - 09.2018
- Provided customer support to patients and PDS-affiliated dental practices via patient support center and email
- Reviewed patients' accounts for insurance billing accuracy
- Addressed collections to satisfy patients' delinquent accounts from 1 to 90+ days past due
- Assisted patients through arranging debt repayment on schedules based on their financial situations
- Complied with HIPAA, state and federal regulations, and Company policies.
Biller / Collections Specialist
CONIFER HEALTHCARE SOLUTIONS
04.2016 - 10.2016
- Managed patients' accounts, billing insurance companies, collecting payments and posting
- Explained EOBs, Co-Pays, and Deductibles to patients daily
- Adhered to all policies, procedures, and local, state, and federal regulations, complying strictly with HIPAA
- Provided exceptional service with integrity to customers and client accounts assigned to the self-pay billing team.
Education
Professional Development Loan Modification Training/Workshop -
Happy Money
Zendesk Training -
Dental Payment Plan Workshop (remedial planning for delinquent customers) -
Pacific Dental Services
Bachelor of Science - Athletic Training
Chaffey College
05-2026
Skills
- Leadership & Teamwork
- Research & Data Gathering
- Client Engagement & Retention
- Analysis & Strategic Planning
- Insurance Billing & Collections
- Result-Driven Self-Starter
- Exceptional Communicator
- Close Attention to Detail
- Adaptable Quick Learner
- Able to Perform Under Pressure
- Time Management & Prioritizing
- Interpersonal & Client Relations
- Critical Thinking & Problem Solving
- Negotiation & Decision Making
- Follow-up & Follow-through
- Computer Skills: Microsoft Office Suite, Google Suite, Outlook, Excel, PowerPoint, Zendesk, CRM, Salesforce, Textline, iOS, Windows, Bolletta Mobile Cashier, Nortridge Loan System, QSIDental
Personal Information
Title: Client Service Representative
Timeline
Fraud Production Specialist
DoorDash
03.2022 - Current
Accounts Receivable Analyst
HAPPY MONEY
04.2019 - 08.2020
Benefits Administrator
CALIFORNIA CHOICE ADMINISTRATORS
10.2018 - 03.2019
Specialist, Insurance Collections
PACIFIC DENTAL SERVICES (NATIONAL SUPPORT CENTER)
01.2017 - 09.2018
Biller / Collections Specialist
CONIFER HEALTHCARE SOLUTIONS
04.2016 - 10.2016
Zendesk Training -
Dental Payment Plan Workshop (remedial planning for delinquent customers) -
Pacific Dental Services
Professional Development Loan Modification Training/Workshop -
Happy Money
Bachelor of Science - Athletic Training
Chaffey College
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