Enterprise Risk Analyst

• Nov 2022 - Present

Supervisor Group Insurance Audit

• Jan 2022 - Oct 2022

 Oversight for the Group and Individual Health Claims audit function for seven (7) Eastern Caribbean territories, Aruba, Barbados, Belize & Trinidad Investigated non-compliance with established claims procedures and provider agreements for the online claims settlement platform Recommended various risk mitigation initiatives for the Southern Caribbean Group Insurance Department, where attainment of strategic goals maybe in danger Trained staff on audit procedures and compliance standards  Reviewed processes and identified areas for standardization across Barbados, the Eastern Caribbean, Belize & Trinidad. Lead the transition of the Southern Caribbean Group Insurance Audit team as a shared service function for Barbados, Trinidad, Belize, the Eastern Caribbean, Aruba and Panama Performed reviews of suspension and termination reinstatement request of non-compliant online claims providers, providing recommendations for management approval Supervised staff members, including management of performance appraisals and on the job coaching and communication of team goals. Ensured that adequate documentation for audits was obtained and performed reviews of audit recommendations by audit staff prior to submission for management approval. Compiled monthly audit information reports for senior management Show less

Claims & Provider Auditor

• Sep 2012 - Dec 2021

 Performed audits and compliance checks for health care providers and claims adjudicators in Barbados, Belize and seven (7) Eastern Caribbean territories Investigated and identified suspicious activity for health claims submissions and anomalous trends in Barbados, Belize & Eastern Caribbean claims portfolio Trained staff in four (4) Eastern Caribbean territories on fraud awareness and prevention processes relating to health insurance claims and key compliance issues Strategized new methods and processes to increase productivity Identified system risks and recommended preventative measures  Compiled monthly audit information reports for senior management  Successfully trained new hires in company procedures and audit processes Performed detailed statistical claims analysis for various group plans Show less

Administrative Assistant

• Aug 2010 - Aug 2012