M A R I S O L S Á N C H E Z T O R R E S
**** * ****** **** *******, FL 32822
787-***-**** *******.*********@*****.***
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