Xavier Cain
Atlanta,GA
Summary
Operations and compliance professional with 9+ years of experience managing high-volume workflows, improving processes, and ensuring regulatory accuracy across complex, detail-driven environments. Known for independent problem-solving, structured documentation, investigation, and coordinating cross-functional work. Brings additional healthcare and pharmacy background with strong analytical, audit-ready execution. Seeking a role that leverages strengths in operations, compliance, and process improvement within a mission-driven organization.
Overview
12
12
years of professional experience
Work History
Desk Adjuster / Operations Specialist
American Family Insurance
Atlanta, GA
09.2021 - Current
- Managed 100+ cases simultaneously, overseeing intake, investigation, documentation, stakeholder communication, and timely resolution.
- Led multi-channel communication with customers, vendors, and legal representatives to ensure timely resolutions.
- Negotiated soft-tissue injury settlements to mitigate risk while ensuring compliance with regulatory standards.
- Mentored peers and facilitated team discussions to enhance decision-making and drive process improvements.
- Produced high-quality documentation, summaries, and evidence reviews for arbitration and quality audits.
Claims Specialist / Process Support Associate
State Farm Mutual Insurance Co.
Atlanta, GA
02.2016 - 01.2021
- Delivered empathetic customer service and technical support to policyholders, clarifying claims processes and coverage options.
- Managed a high-volume caseload efficiently while ensuring attention to detail and adherence to regulatory deadlines.
- Conducted initial claims investigations by gathering statements, reviewing evidence, and evaluating liability and coverage applicability.
- Facilitated communication between insureds, repair facilities, rental providers, and third-party carriers to expedite claims resolution.
- Mentored newly hired claims associates, delivering training on best practices in claims handling.
Certified Pharmacy Technician (CPhT)
Aids Healthcare Foundation, AHF
Lithonia, Georgia
01.2014 - 02.2016
- Processed prescriptions and managed sensitive health data in accordance with HIPAA, and regulatory requirements.
- Performed daily cycle counts to monitor medication inventory levels and storage conditions.
- Communicated effectively with doctors, and insurance companies, to resolve prescription cost discrepancies.
- Delivered comprehensive HIV education, including outreach initiatives, and copay assistance for patients.
- Consulted with patients regarding medication usage and side effects to promote treatment compliance.
Education
Bachelor of Business Administration -
Georgia State University
Atlanta, GA05-2012
Skills
- Operational Workflow Management
- Process Improvement & Efficiency Optimization
- Regulatory & Compliance Support
- Investigation & Research Analysis
- Audit-Ready Documentation & Quality Assurance
- Cross-Functional Coordination
- Policy & Procedure Interpretation
- Risk Identification & Issue Resolution
- Training & Onboarding
- Healthcare/Pharmacy Operations Knowledge
- Vendor & Partner Coordination
- CRM & Tools (Salesforce, Microsoft Office, Excel)
Timeline
Desk Adjuster / Operations Specialist
American Family Insurance
09.2021 - Current
Claims Specialist / Process Support Associate
State Farm Mutual Insurance Co.
02.2016 - 01.2021
Certified Pharmacy Technician (CPhT)
Aids Healthcare Foundation, AHF
01.2014 - 02.2016
Bachelor of Business Administration -
Georgia State University