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senior regulatory compliance analyst resume example with 19+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
  • :
Summary

Seeking a role that encompasses a wide range of responsibilities in the field of Compliance, particularly investigations and monitoring. Hardworking and reliable with strong ability to get to the root cause of an issue and follow through with corrective action. Critical thinker and detail oriented with ability to make quick decisions with best information available at the time. Highly organized, proactive and punctual with team-oriented mentality but have experience in working solo.

Skills
  • Compliance and Ethics Interview Techniques
  • Data Analysis
  • SharePoint Administration
  • Policy Development
  • Audit Coordination
  • Risk Identification and Assessment
  • Database Management
  • Conflict Management
  • Compliance Reporting
  • Policy Enforcement
  • Process Implementation
  • Risk Mitigation
  • Audit Documentation
  • Privacy and Confidentiality
  • Compliance Training
  • Powerpoint Presentations
  • Critical Thinking
  • Continuous Improvement
Experience
Senior Regulatory Compliance Analyst, 01/2018 to Current
Axis Capital Holdings LtdChicago, IL,
  • Monitor Medicare Advantage and Affordable Care Act guidance and regulations. Educate business areas and ensure compliance through various monitoring activities.
  • Facilitate various workgroups including various levels of associates, in improving quality and developing sustainable processes.
  • Analyze and audit data for various business areas and identify non-compliance or opportunities for improvement.
  • Facilitate internal reviews and coordinate both internal and external audits with government agencies and contracted vendors.
  • Present complex issues and resolution of issues to government entities.
  • Ongoing monitoring of Medicare Advantage risks through identification and testing of controls.
  • Attend monthly Alabama Chapter for Certified Fraud Examiners.
  • Technical
  • Developed and manage internal Medicare Advantage SharePoint site as well as electronic workflow processes.
  • Developed trending and analysis reports for operational areas to aid in taking action where appropriate.
  • Data mining for Medicare reporting including claims, enrollment, compensation, provider network adequacy.
  • Develop reporting in Archer tool
  • Crystal Reporting
  • Leadership
  • Coach peers on advancing through projects.
  • Mentor new staff in the department.
  • Lead projects and delegate responsibilities.
  • Present risk assessment to Internal Audit leadership.
  • Make decisions based on information available.
  • Graduate of Blue Cross and Blue Shield of Alabama Pathways for Leadership program.
HIPAA Compliance Analyst and MAC J10, 02/2008 to 01/2018
Cahaba Government Benefit Administrators, LLCCity, STATE,
  • Coordinate and implement HIPAA Privacy policies and procedures
  • Administer company operating policies to include updates and manage acknowledgment
  • Analyze conflict of interest disclosures and recommend mitigations
  • Monitor and audit mitigations
  • Investigate unauthorized disclosures of PHI/PII and provide immediate reporting and corrective action to appropriate government agencies
  • Investigate reports of alleged non-compliance. Follow through with corrective action to include counseling, discipline up to termination
  • Develop training and ensure all associates receive adequate training under HIPAA and Medicare and general Compliance Programs
  • Online coursework as well as interactive group sessions with video and discussion
  • Hold quarterly focus groups with various departments
  • Research, implement, analyze and monitor various department projects designed to maintain compliance with federal regulations and company policies
  • Collaborate with Quality Management Office on corrective preventive action plans for non-conformities
  • Support and facilitate external audits
  • Conduct ongoing compliance and HIPAA risk analysis
  • Prepare and present Board training and reports
  • Technical
  • Developed online breach notification form in SharePoint
  • Developed departmental SharePoint site
  • Redesigned Code of Business Conduct with user-friendly features
  • Managed Access Database
Asset Management Analyst (Sr. in 2006), 02/2003 to 02/2008
Blue Cross And Blue Shield Of AlabamaCity, STATE,
  • Responsible for ensuring the accuracy of asset information including adding new acquisitions, monitoring existing assets, and crediting disposed assets.
  • Provide accurate information and documentation to accounting for IRS deductions and Medicare allocations.
  • Research and analyze historical data which may involve sensitive information.
  • Perform quality assurance to ensure accuracy of database information.
  • Cooperate on a daily basis with HIPAA, Information Security, and Medicare personnel to ensure Corporate Asset Management is compliant in managing corporate assets, particularly information technology assets.
  • Developed detailed policy and procedures for managing corporate assets and laptop security in coordination with HIPAA guidelines. 
  • Communicate, educate, and work with all levels of associates as well as external auditors, vendors and service personnel.
  • Technical
  • Accounts Payable
  • Crystal Reporting
  • Magic Solutions
  • Purchase Order System
  • Fixed Asset System
  • Gariston Database
  • Epicor
  • Autodesk
  • Excel
Education and Training
Courses in Problem Solving and Transformational Leadership: , Expected in 2006 to University of Phoenix - Phoenix, AZ
GPA:
Bachelor of Science: Elementary Education, Expected in 05/2002 to University of Montevallo - Montevallo, AL
GPA:
Gariston 1999-2002
  • Member of Kappa Delta Pi (International Honor Society in Education; Encourages high professional, intellectual and personal standards, and recognizes outstanding contributions to education.)
  • Member of Pi Lamda Theta (International Honor Society and Professional Association in Education)
  • : , Expected in 1998 to Jefferson State Community College, University of Montevallo - Centerpoint, AL
    GPA:
    Certifications
    • Certified Fraud Examiner; Association of Certified Fraud Examiners; 2013
    • Certified Compliance Professional; Health Ethics Trust; 2012-2021
    ,
    Additional Information
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    Resume Overview

    School Attended

    • University of Phoenix
    • University of Montevallo
    • Jefferson State Community College, University of Montevallo

    Job Titles Held:

    • Senior Regulatory Compliance Analyst
    • HIPAA Compliance Analyst and MAC J10
    • Asset Management Analyst (Sr. in 2006)

    Degrees

    • Courses in Problem Solving and Transformational Leadership
    • Bachelor of Science

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