M A R I S O L S Á N C H E Z T O R R E S

**** * ****** **** *******, FL 32822

787-***-**** acgurd@r.postjobfree.com

As a knowledgeable and dedicated professional with over 15 years’ experience, I seek to bring my

management, program development, training, quality assurance and audit skills to add value to

your organization.

• Internal Audit, Ethic, Conducting the Internal Audit Engagement Communicating Results &

Monitoring Progress Information Technology Statistics and Sampling, Business Analysis

and Information Technology Applied to Internal Auditing.

Extensive training experience, responsible for the development of training programs and

coaching numerous new employees.

Highly organized and self motivated with positive attitude, dedicated to the successful

completion of all organizational objectives.

Excellent written and oral interpersonal communication skills, fluent in both English and

Spanish.

Able to perform multiple assignments under pressure and consistently meet deadlines.

Strong computer knowledge: PowerPoint, Excel, Microsoft Word, Internet, Outlook, NICE,

Market Prominence, EZ Cap, Compass, Sanovia, Onbase, QNXT, MedHok, C3PO, Net Claims

etc.

Professional Experience

MMM Healthcare PLan

Quality Analyst 2008 – 9/9/2014

Conduct internal audits, collecting, analyzing, and reporting on financial data to detect deficient controls,

duplicated effort or fraud.

Ensure total compliance with established internal control procedures, laws and regulations by examining

records, reports, operating practices and other aspects of business.

Build, develop and administer leadership training programs for new employees, including personal

coaching and the creation of presentations and manuals.

Monitor monthly calls for each Representative Department, including Member Services, Pharmacy and

Provider.

Coordinate with administration, department managers and corporate personnel to formulate effective

policies and procedures in compliance with established standards.

Maintain a comprehensive updated database of employee monitoring and reports.

Compile, prepare and accurately maintain a variety of standard operating records and reports.

React quickly, efficiently and calmly in emergencies and other high stress situations while following all

relevant protocol.

M A R I S O L S Á N C H E Z T O R R E S

Phone: 787-***-**** Page 2

Support call handling, issue and grievance resolution in a polite and professional manner at all times.

Ensure that Call Center Representatives comply entirely with the HIPAA Law.

Customer Service Representative, 2006 – 2008

Communicated with internal and external providers, customers or clients by phone as a member of the

inbound and outbound call unit.

Worked a wide range of different computer tools, including Material Request, English Quit, Eligibility,

Authorization, Right Fax, Pro Health, Market Prominence, Ez Cap, Excel, Online Provider Directory, E

mail, Microsoft, OneNote and Compass.

Participated in in service and other training programs to improve service offered.

Professional Experience (Continued)

RG Bank

Assistant Administration, 2004 – 2006

Used appropriate grammar, spelling, computer/industry terms and acronyms to routinely compose and

create memorandum, reports, correspondence, forms and statistical data.

Confirmed all the appointment with telemarketing, giving all the production informs to the Process

Officer.

Updated HMDA informs, including cancel, withdraws, closing and inactive cases, “Daily Deposit” and

ensure that the “Petty Cash” is correct with the vouchers.

Communicated with staff to ensure that accurate documentation was received, issued instructions and

responded to verbal/written inquiries and requests or referred to appropriate staff member.

Established and maintained effective working relations with others and correctly managed difficult

interpersonal contacts.

CCA Corrections Corporation of America

Assistant Administration, 1998 – 2002

Created and organized files, sorting, labeling, filing and retrieving in accordance with corporate and

facility file retention and storage procedures.

Maintained total confidentiality and security when handling sensitive records.

Obtained information regarding threat assessment, inmates counts, post orders, special instructions,

informs, memorandums, reunion organizations and confidential informs.

Read and analyzed a wide range of legal and non legal documents, including policies, regulations,

procedures, reports, technical procedures and governmental regulations.

Complied at all times with regulations, laws, rules, procedures, policies, standards and contracts.

M A R I S O L S Á N C H E Z T O R R E S

Phone: 787-***-**** Page 3

Established effective reports and procedures to informs, policies, job descriptions, post orders and

emergency plans.

Education

Bachelor Degree in Administrative Assistant

Universidad Del Este, 1994 – 1999

Certified Medical Compliance Officer (CMCO)

American Institute of Health Compliance INC, Oct. 2014 April 2015

Certification Internal Auditor IIA Puerto Rico

JLMA LEARNING CENTER 2014

Internal Audit, Ethic, Conducting the Internal Audit Engagement Communicating Results

& Monitoring Progress, Information Technology, Statistics and Sampling, Business Analysis

and Information Technology.

Mentoring and Coaching Skills

Fred Pryor Seminars, 2013

HIPAA Certification

Universidad Sagrado Corazon, 2010

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