Experience

Oshi Health

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Compliance Project Manager

  • Oct 2022 - Present



Oscar Health

• United States
• Insurance
• 700 & Above Employee

• Compliance Associate

  • Dec 2021 - Oct 2022



Ontrak Health

• United States
• Mental Health Care
• 1 - 100 Employee

• Compliance Analyst

  • Jul 2020 - Nov 2021



Anthem, Inc.

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Compliance Policy/Training Consultant

  • Dec 2019 - Jul 2020

  Responsible for overseeing the Medicare Revenue department’s policies and procedures (P&P’s) and working with departments to ensure policies are up to date and published for staff access. Oversee multiple compliance projects till completion related to risk adjustment. Utilize Compliance 360 to review CMS guidance that may impact Medicare Revenue business. Monitor and track all open Medicare Revenue items on the risk registry till closure. Responsible for overseeing the Medicare Revenue department’s policies and procedures (P&P’s) and working with departments to ensure policies are up to date and published for staff access. Oversee multiple compliance projects till completion related to risk adjustment. Utilize Compliance 360 to review CMS guidance that may impact Medicare Revenue business. Monitor and track all open Medicare Revenue items on the risk registry till closure.



HealthPlan Services

• United States
• Insurance
• 200 - 300 Employee

• Compliance Analyst

  • Sep 2017 - Nov 2019

  Ensured that all policies and procedures were implemented and well documented on an annual basis or when new regulations were released. Acted as the secretary for the Policy and Procedure Subcommittee and Corporate Compliance Committee meetings. Coordinated client and internal staff corrective action plans for remediation of findings found during internal and external audits. Work alongside the company’s internal auditor to conduct mocks audits and audit prep for upcoming audits. Reported status of remediation of corrective action plans and policies & procedures to the Compliance Committee on a monthly basis. Track and report progress of external audits and remediation of corrective action plans weekly to corporate executives. Created and distributed the monthly Compliance Newsletter. Show less



Access Health CT

• United States
• Government Administration
• 1 - 100 Employee

• Health Plan Process Coordinator, Jr. Business Analyst

  • May 2016 - Aug 2017

  Acted as the company’s JIRA ticketing system subject matter expert, as well as a health insurance carrier contact. In addition to maintaining the JIRA system, and overseeing Electronic Data Interface (EDI) processes I was responsible for organizing weekly meetings with the Business Case Development team to approve/reject system issues or enhancement tickets. I was similarly tasked with assisting the IT and Customer Support departments through log evaluations, customer outreach, and issue resolutions. Show less

• Health Plan Analyst Trainee

  • May 2015 - May 2016

  Provided data analysis for health carriers’ network adequacy and member access via Maptitude. Monitored the annual Qualified Health and Stand-Alone Dental plans certification/re-certification, and System for Electronic Rank and Form Filing (SERFF) data submission. Conducted quality assurance reviews,including data validation and documentation for revisions and re-submissions in SERFF. Communicated between carriers and the Connecticut Insurance Department (CID) through teleconferences and webinars, while frequently interacting with the Center for Medicaid and Medicare Services (CMS) to support Access Health CT’s Plan Management Portal (PMP). Show less

• Enrollment Specialist

  • Sep 2014 - Apr 2015

  Provided customer service to consumers enrolling in Medicaid and Qualified Health Plans (QHP). Provided support to consumers encountering application issues, needed to report changes, and answer and questions they may have regarding the On-Exchange health plans or the Affordable Care Act (ACA). Along with coordinating Medicaid enrollments in conjunction with the Department of Social Services (DSS) and other health carriers and brokers. After open enrollment, I assisted the Issue and Resolution Department (IRD) with various consumer issues (fixing coverage dates and tax credits). Show less



Hertz

• United States
• Travel Arrangements
• 700 & Above Employee

• Management

  • Dec 2013 - Jul 2014

  • Prepare the day for reservations by getting cars ready, verifying reservations with special equipment, transport vehicles to contracted locations outside our office. • Perform office duties such as, answer the phone, file paperwork, create reservations, complete cash audits, and make sure the office is organized. • Provide customer service by completing leisure rentals (ASAP) and insurance replacement rentals (HLES), using S.M.I.L.E.S, and making sure the customer leaves with a good experience. Show less



CREC-Metropolitan Learning Center

• Bloomfield, CT

• Office Assistant/ Intern

  • Jan 2013 - Apr 2013

  • Plan and execute annual Career Fair and Latin Festival, including event preparation, registration, site layout(s), and management • Perform general office duties, including filing and appointment scheduling • Coordinate Latina Youth Group programs and mentoring activities • Plan and execute annual Career Fair and Latin Festival, including event preparation, registration, site layout(s), and management • Perform general office duties, including filing and appointment scheduling • Coordinate Latina Youth Group programs and mentoring activities



University of Hartford-Student Centers Administation

• West Hartford, CT

• Office Assistant

  • Aug 2012 - Apr 2013

  Provide administrative support to office manager • Serve as first point of contact for students, faculty, staff and visitors to the office • Receive and escort visitors to meeting/event locations Provide administrative support to office manager • Serve as first point of contact for students, faculty, staff and visitors to the office • Receive and escort visitors to meeting/event locations



Stanwich Country Club

• Greenwich, CT

• Summer Camp Counselor

  • Jun 2012 - Aug 2012

  -Provided arts and crafts activities for the kids participating in the camp. -Assisted camp counselors with activities. -Supervised kids ages 3-12 -Provided arts and crafts activities for the kids participating in the camp. -Assisted camp counselors with activities. -Supervised kids ages 3-12



University of Hartford-Student Centers Administrations

• West Hartford, CT

• Game Room Attendant

  • Apr 2010 - May 2012

  • Oversee purchases and game rentals • Manage game room inventory and equipment upkeep • Handle cash and credit receipts and serve as first point of contact with student/guest patrons • Verify accuracy of daily cash records • Oversee purchases and game rentals • Manage game room inventory and equipment upkeep • Handle cash and credit receipts and serve as first point of contact with student/guest patrons • Verify accuracy of daily cash records



Lord + Taylor

• Retail
• 700 & Above Employee

• Seasonal Sales Associate

  • Nov 2011 - Jan 2012

  -Worked the cash register. -Provided customer service -Organized merchandise -Floated around different parts of the store. Worked dresses, coats, sleep wear, and shoes department. -Worked the cash register. -Provided customer service -Organized merchandise -Floated around different parts of the store. Worked dresses, coats, sleep wear, and shoes department.



Walt Disney World

• United States
• Entertainment Providers
• 700 & Above Employee

• Quick Service Food & Beverage

  • Aug 2010 - Jan 2011

  • Handled cash and credit receipts, prepared food and stocked beverages, cleaned condiment bar and food stand, bused tables. • Completed magical moments, which included giving a random guest(s) a special something for free to make their day. • Excelled within company’s service-oriented model, demonstrating a talent for communicating effectively with customers from diverse backgrounds. • Handled cash and credit receipts, prepared food and stocked beverages, cleaned condiment bar and food stand, bused tables. • Completed magical moments, which included giving a random guest(s) a special something for free to make their day. • Excelled within company’s service-oriented model, demonstrating a talent for communicating effectively with customers from diverse backgrounds.