General Virtual Assistant | Medical Virtual Assistant | HIPAA Certified

Investigated, analyzed, and resolved complex healthcare subrogation and lien recovery claims, ensuring accurate identification, negotiation, and collection of third-party liability to maximize financial recovery. Progressed from Subrogation Claims Processor to Senior Process, managing high-complexity claim types including Subrogation, Workers’ Compensation, Single Motor Vehicle, Product Liability, Medical Malpractice, and Property claims. Led and supported operational efficiency initiatives by developing automation solutions, a Time and Motion Production Tracker for onshore and offshore teams, and macro tools to streamline insurance contact data management. Performed ad hoc tasks such as case summary preparation, database maintenance, coordination with legal teams and insurers, and process improvement support to ensure timely and accurate claim resolution. Consistently recognized for outstanding performance and quality, earning multiple Opal Awards as Top Processor, Lean Six Sigma Certification with a cost-savings project of $19,538, and honors including Innovation Award, Macro Champion, Elite Award, and Directors Club (2016–2018). Maintained Quality Certification with zero external errors. As a Subject Matter Expert for the Cost Recovery Department, managed high-volume contract retrieval and review, verifying agreement counts across workstreams and identifying key clauses and required terms. Extracted and validated critical data into Excel databases for tracking, reporting, and analysis. Supported cross-functional teams through targeted contract searches, custom reporting, and time-sensitive special projects, consistently delivering accurate results under tight deadlines. Recognized as a Consistent Quality Champion Awardee.

Responsible for investigating, analyzing, and resolving healthcare claims related to subrogation and lien recovery. Ensures accurate identification, negotiation, and collection of third-party liability to optimize financial recovery. Performed various ad hoc tasks such as preparing case summaries, updating internal databases, coordinating with legal teams and insurers, and supporting process improvements to ensure timely and accurate lien resolution. Began as a Subrogation Claims Processor and promoted to Senior Process, handling complex claim types including Subrogation, Workers' Compensation, Single Motor Vehicle, Product Liability, Medical Malpractice, and Property claims. Played a key role in enhancing operational efficiency by initiating automation processes, developing a Time and Motion Production Tracker for both onshore and offshore teams, and creating a macro tool for streamlined insurance contact data management. Ensured accurate claim processing and contributed to continuous process improvement within the Subrogation unit. Consistently recognized for excellence, including multiple Opal Awards as Top Processor, Lean Certification with a Six Sigma project saving $19,538.00 and key honors such as Innovation Award, Macro Champion, Elite Award, and Directors Club from 2016 to 2018. Maintained Quality Certification with zero external errors.

As a Subject Matter Expert for the Cost Recovery (COR) Load Team, I served as the primary point of contact for technical process requirements, leading client calibration sessions, business process meetings, and supporting SOW execution. I helped manage the daily operations of the Claims Department, including workflow distribution, production monitoring, and issue resolution, while also participating in internal audits for ISO27001 and HIPAA compliance. Additionally, I was an active member of cross-functional teams such as PPAT, Operational Excellence, and Information Security, and was cross-trained in Facets Cash Adjustments and various Wellpoint systems. Regularly performed ad hoc tasks including system data validation, special claims investigations, and support for cross-functional audits and internal reviews. Assisted in urgent process escalations, provided training support for new hires, and contributed to event coordination and project-based initiatives such as Project Neptune and Operational Excellence. Flexibly responded to shifting priorities by offering technical expertise and administrative support across multiple systems and teams. Recognized as a Consistent Quality Champion, demonstrating exceptional accuracy and performance across core responsibilities. Awarded Most Valuable Processor multiple times in 2010 and 2011 for consistently exceeding productivity and quality benchmarks. Honored as Subject Matter Expert of the Year 2014 for outstanding expertise and contributions to the Cost Recovery – Facets team. Successfully completed iADSS – Wave 30 under the Accenture Delivery Skills Program (ADSP), enhancing leadership and delivery capabilities.

As a Contracts Inventory Analyst and Quality Auditor, I was responsible for retrieving contracts from internal systems and verifying the total number of agreements in accordance with established workstreams. I reviewed a high volume of contracts to identify specific clauses and required terms. Key data points were then extracted and accurately entered into an Excel database for tracking and analysis. Handled various ad hoc tasks as needed, including conducting targeted contract searches, preparing customized reports, and supporting special projects requiring quick turnaround. Assisted cross-functional teams by providing timely data extraction, analysis, and validation from contract documents. Adapted to shifting priorities and delivered accurate results under tight deadlines. Recognized as Consistent Quality Champion Awardee

Served as Nationwide Management Support for a construction company catering to private and government infrastructure projects, overseeing payroll operations, project analysis, commission disbursement, and end-to-end project management across multiple sites nationwide. Ensured efficient execution, compliance, and on-time delivery of projects while managing workforce compensation and performance monitoring. Handled various ad hoc tasks including report preparation, coordination with regional teams, documentation, issue resolution, and support for executive and project-related needs to ensure smooth daily operations.

Experienced in end-to-end medical insurance claims processing with a strong focus on subrogation, lien recovery, and third-party liability. Investigated, analyzed, and resolved complex healthcare claims to ensure accurate adjudication, compliance, and maximum financial recovery. Progressed from Claims Processor to Senior Process, handling high-complexity claim types including Subrogation, Workers’ Compensation, Single Motor Vehicle, Product Liability, Medical Malpractice, and Property claims. Performed detailed claims review, verification, and documentation while coordinating with insurance carriers, legal teams, and internal stakeholders to support timely and accurate claim resolution. Managed ad hoc tasks such as case summaries, system updates, data validation, and process support to maintain operational efficiency and regulatory compliance. Played a key role in process optimization by initiating automation solutions, developing a Time and Motion Production Tracker for onshore and offshore teams, and creating macro tools to improve insurance contact management and claims turnaround time. Consistently delivered high-quality output while maintaining strict quality and compliance standards. Recognized for excellence in claims processing and quality performance, earning multiple Opal Awards as Top Processor, Lean Six Sigma Certification with a $19,538 cost-savings project, and honors including Innovation Award, Macro Champion, Elite Award, and Directors Club (2016–2018). Maintained Quality Certification with zero external errors. As a Subject Matter Expert for Medical Cost Recovery, supported claims operations through high-volume contract review, verification of agreement terms, and accurate data extraction for claims validation and recovery tracking. Provided targeted reports, data analysis, and cross-functional support to ensure accurate claims handling under tight deadlines. Recognized as a Consistent Quality Champion Awardee.