Xaria James
Miami Beach,FL
Summary
Detail-oriented Financial Operations Specialist with over four years of experience in healthcare finance and operations. Proven track record in optimizing financial processes, ensuring regulatory compliance, and enhancing budget management. Expertise in financial reporting, cost analysis, and revenue cycle management, combined with a strong ability to leverage data-driven insights to drive strategic decision-making. Adept at collaborating with cross-functional teams to streamline operations and implement effective financial strategies. Committed to improving financial performance and operational efficiency in healthcare settings.
Overview
9
9
years of professional experience
Work History
Financial Operations Specialist
Elevance Health
08.2022 - Current
- Conduct thorough investigations for accurate claim evaluations, minimizing company losses.
- Uphold strict confidentiality standards while handling sensitive customer information and documents.
- Adhere to all company policies and procedures when making decisions regarding claims adjustments.
- Maintained a high level of accuracy in data entry and processing tasks, reducing discrepancies in claim records.
- Demonstrated exceptional attention to detail when analyzing financial statements for accurate adjustments.
- Evaluated and settled complex insurance claims in strict timeframes.
- Played an integral role in the successful implementation of new accounting software that streamlined financial operations.
Claims Representative Associate
Elevance Health, Simply Healthcare Plans
08.2021 - 08.2022
- Handle complex claims with a good understanding of the application of benefit contracts, pricing, processing, policies, procedures, government regs, coordination of benefits, healthcare terminology and/or adjust claims.
- Good working knowledge of claims and products, including the grievance and/or re-consideration process..
- Reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and entitlement.
- Researches and analyzes claims issues.
- Responds to inquiries, may involve customer/client contact.
Customer Service Representative I
Elevance Health, Simply Healthcare Plans
08.2020 - 08.2021
- Educate members about plan benefits, contracted physicians, facilities, and healthcare providers
Volunteer Relations Manager
National LGBTQ Task Force | Winter Party Committee
03.2019 - Current
- Using various techniques to recruit volunteers, and responding to individual inquirie
- Keeping and managing volunteer information, and integrating the volunteer database with the donor database
- Helping assess volunteer skills, and assigning volunteers to specific projects and tasks
Complex Revenue | Sales Manager
Broadmoor Miami Beach & Ocean Surf Hotel
11.2018 - 07.2019
- Revenue maximization efforts for the assigned properties through monitoring segmentation mix, to ensure profitability and growth versus prior year and the competitive set
Operations Manager
Hertz | Dollar | Thrifty
02.2018 - 10.2018
- Manage, Hire, & Train a team of 75 Rental Car Agents & Monitor Performance
Relief Overnight Manager
Westdrift, Marriott Autograph Collection
09.2017 - 01.2018
- Attended and participated in regional conferences to maintain up-to-date hospitality industry knowledge
Front Office Manager
Kimpton Palomar Hotel
08.2017 - 12.2017
- Effectively create and develop SOP's to ensure quality and performance standards
Front Office Manager
Uber Xchange Leasing
11.2015 - 09.2017
- Direct the business operations, personnel administration & financial portfolio for Uber Corporate
Education
Executive Hospitality Management Certificate -
Florida Atlantic University
01.2020
B.S. in Business Hospitality Management and Tourism -
Johnson and Wales University
01.2016
Skills
- Operations Management
- Vision & Strategic Goal Planning
- Organizational Leadership
- Policy & Procedure Implementation
- Quality Compliance and Control
- Consumer & Competitor Data Analytics
- Proficient in Microsoft Office applications
- Excellent oral communication skills
Additional Information
Board Positions
University of Miami -Miami Center for AIDS Research (CFAR)
University of Miami- Gender Minority Research Community Advisory Board (CAB)
TransSocial Inc.
Timeline
Financial Operations Specialist
Elevance Health
08.2022 - Current
Claims Representative Associate
Elevance Health, Simply Healthcare Plans
08.2021 - 08.2022
Customer Service Representative I
Elevance Health, Simply Healthcare Plans
08.2020 - 08.2021
Volunteer Relations Manager
National LGBTQ Task Force | Winter Party Committee
03.2019 - Current
Complex Revenue | Sales Manager
Broadmoor Miami Beach & Ocean Surf Hotel
11.2018 - 07.2019
Operations Manager
Hertz | Dollar | Thrifty
02.2018 - 10.2018
Relief Overnight Manager
Westdrift, Marriott Autograph Collection
09.2017 - 01.2018
Front Office Manager
Kimpton Palomar Hotel
08.2017 - 12.2017
Front Office Manager
Uber Xchange Leasing
11.2015 - 09.2017
Executive Hospitality Management Certificate -
Florida Atlantic University
B.S. in Business Hospitality Management and Tourism -
Johnson and Wales University