Veronique Underwood-Wright
Sunrise,FL
Summary
Experienced in Business Management skilled in budget review, reporting, and research. Top-notch administrator with a financially savvy and organized approach. Familiar with helping business leaders understand all facets of operations. Accomplished Consultant drives organizational improvements through leveraging expertise in research and system enhancement. Well-versed in collaborating with employees and leaders to resolve control and procedural problems negatively affecting business operations. Dedicated to cost, process, and resource optimization.
Overview
13
13
years of professional experience
Work History
Compliance Auditor
CHG/Locumsmart Healthcare
03.2021 - Current
- Enhanced regulatory compliance by conducting thorough audits and identifying areas for improvement.
- Reduced financial risks through meticulous analysis of financial statements, internal controls, and operational procedures.
- Strengthened overall corporate governance with comprehensive audit findings and actionable recommendations.
- Collaborated with cross-functional teams to ensure timely implementation of corrective actions, mitigating potential compliance issues.
- Provided expert guidance on compliance requirements, ensuring informed decision-making across theorganization.
- Streamlined internal processes by identifying inefficiencies in the existing control systems and recommending improvements.
- Delivered comprehensive training programs for employees on key compliance topics, fostering a sound understanding of relevant regulations and best practices.
- Collaborated with accounting manager to comply with governing bodies and limit regulatory risks.
- Tracked funds, prepared deposits and reconciled accounts.
- Collected and reported monthly expense variances and explanations.
- Compiled general ledger entries on short schedule with 100% accuracy.
- Identified legal tax savings and recommended ways to improve profits.
- Reviewed accounts, resolved coding areas, and tracked recurring expenses for accrual entry.
- Developed financial models to assess and analyze financial performance of clients.
- Developed robust risk assessment frameworks to systematically identify, evaluate, and prioritize organizational risks.
- Fostered a culture of accountability by regularly monitoring adherence to regulatory guidelines and reporting non-compliance instances to senior management.
- Maintained up-to-date knowledge of regulatory changes affecting the business landscape, proactively adapting audit strategies as needed.
Medical Claims Examiner/Lead
LA Care Health Plan
08.2015 - 03.2021
- Enhanced claim processing efficiency by conducting thorough investigations and maintaining accurate documentation.
- Streamlined workflow for faster resolution of medical claims through effective prioritization and organization.
- Reduced errors in claim submissions by meticulously reviewing patient information and verifying insurance eligibility.
- Identified fraudulent activities by analyzing patterns, trends, and discrepancies in medical claims data.
- Maintained compliance with industry regulations and company policies while evaluating medical claims for accuracy and legitimacy.
- Increased productivity by implementing efficient strategies for handling high volumes of medical claims daily.
- Negotiated fair settlements with healthcare providers to minimize financial risk while ensuring adequate compensation for services rendered.
- Evaluated the necessity of additional treatments or procedures based on established criteria, protecting patients from unnecessary interventions or costs.
- . Achieved excellent outcomes for both patients and healthcare providers by applying sound judgment in adjudicating complex medical claims.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures, and HIPAA regulations.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.
- Collaborated with healthcare providers to obtain necessary medical records, ensuring timely and accurate claim adjudication.
- Improved interdepartmental communication by fostering a collaborative environment and sharing vital information regarding complex cases.
- Identified and resolved discrepancies between patient information and claims data.
Member Services Manager
Molina Healthcare
03.2011 - 08.2015
- Improved member satisfaction by addressing concerns and providing timely resolutions.
- Enhanced communication among team members, which resulted in increased efficiency and productivity.
- Streamlined processes for membership registration, leading to reduced wait times and improved customer experience.
- Developed targeted marketing campaigns that drove membership growth and retention rates.
- Managed a team of staff members, providing coaching and professional development opportunities, resulting in overall improvement in performance metrics.
- Implemented strategies to increase member engagement through social media platforms and email campaigns.
- Collaborated with other departments to develop comprehensive programs catering to the diverse needs of our members.
- Organized special events for members, fostering a sense of community and promoting loyalty within the organization.
- Conducted regular analysis of membership data to identify trends and areas for improvement, leading to informed decision-making on program offerings.
- Provided exceptional customer service by promptly addressing inquiries and resolving issues related to memberships or facility use.
- Maintained accurate records of all member interactions, ensuring compliance with privacy regulations and enabling better tracking of concerns or complaints.
- Evaluated current services offered based on feedback from both members and employees to make necessary adjustments or improvements where needed.
- Built strong relationships with local businesses to create exclusive offers for our members, increasing perceived value as well as enhancing community partnerships.
- Developed incentives programs aimed at motivating staff members to maintain high standards in their daily tasks while also encouraging innovation within the team.
- Implemented a system for tracking and analyzing member feedback, allowing us to identify areas where improvements could be made and measuring the success of implemented changes.
- Managed budgets for membership programs and services, ensuring cost-effectiveness without compromising on quality or member satisfaction levels.
- Spearheaded initiatives that fostered a culture of continuous improvement within the organization, driving positive change in both internal processes and member-facing services.
Education
Medical Billing/Medical Terminology Certificate - Medical Terminology & Medical Billing
Chester Medical School
06.2010
Bachelor of Arts - Business Management
Edward Waters University
06.2008
Skills
- Auditing Experience
- Finance Reimbursement Knowledge
- Auditing and Attestation
- Critical Thinking and Analysis
- Negotiation and Conflict Resolution
Timeline
Compliance Auditor
CHG/Locumsmart Healthcare
03.2021 - Current
Medical Claims Examiner/Lead
LA Care Health Plan
08.2015 - 03.2021
Member Services Manager
Molina Healthcare
03.2011 - 08.2015
Medical Billing/Medical Terminology Certificate - Medical Terminology & Medical Billing
Chester Medical School
Bachelor of Arts - Business Management
Edward Waters University
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