MARIKO UBALE

Schaumburg, IL Phone: +1-708-***-**** Email: adue77@r.postjobfree.com

PROFESSIONAL SUMMARY:

Passionate result-oriented Analyst with in-depth understanding of complex HIPAA Compliance Settings, Incidences and there need to be addressed in an expedient manner to avoid negative regulatory repercussions.

Adept in monitoring AML/BSA trends for related industry practices and evaluated transactions for Fraud and Money laundering activities within AML framework along with reviewing negative feeds of OFAC/Watch List/PEP alerts generated by automated systems. Competent in Customer Onboarding, Risk assessment and preparing required reports including Suspicious activity reports (SARs). SKILLS & EXPERIENCE:

Interpersonal skills Time management Teamwork Professionalism Analytical skills Adaptability Critical thinking Problem solving Proficient in the use of World base, World check, PDF creator, Xerox, RDC, ECRR (Enterprise Client Risk Rating), DDIQ, Pivot tables, Excel, Clear, Lexis Nexis, MS Office 365 Word, PowerPoint, Excel, SQL, JIRA, Visio, ERP (Microsoft Dynamics, Produce Pro, SAGE) and quit a few more interesting and beneficial skills I could add to your business organization.

PROFESSIONAL WORK HISTORY:

Compliance Analyst: Mercy Hospital and Medical Center Chicago, IL. 02/2018 to 06/2021

Perform compliance reporting; and develop and implement compliance auditing and monitoring strategies.

Respond to external requests for information required by the organization for its regulatory filings.

Identify, investigate, and resolve HIPAA incidents.

Track and trend HIPAA incidents to assists Compliance in providing targeted HIPAA training.

Respond to inquiries from state and federal regulatory agencies.

Monitor pending legislation and regulations affecting Centene Corporation services.

Maintain database and other reference materials related to legislative and regulatory issues and compliance.

Communicate state and federal requirements to internal and external clients.

Provide development guidance and assists in the identification, implementation, and maintenance of compliance policies, procedures and work instructions.

Assist in the identification, analysis, and resolution of compliance issues.

Maintain and reviews regulatory documentation necessary to maintain corporate standards.

Assist in developing, producing and conducting compliance training programs.

Perform periodic compliance audits, risk assessments and conducts related ongoing compliance monitoring activities.

Assist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to members.

Plan, direct and coordinate the implementation of Compliance Committee policy to ensure decisions are properly executed.

Serve as a companywide resource and liaison on policies, contract issues and provisions, communications, workflow, and quality improvements initiatives.

Process and submit weekly 401(k) funding to plan administrator, Analyze and research financial and indicative file errors, perform on-going data review and analysis of vendor and employee data to ensure accuracy of data and processes of retirement plan.

Researches and prepares cases for clinical and legal review. AML/Fraud Security Specialist: Fidelity Investment Boston, MA. 03/2016 to 01/2018

Conduct appropriate levels of due diligence on accounts based on the customer’s risk score.

Performs AML alert reviews derived from alert and non-alert-based sources, such as incident reports submitted by Bank employees.

Researches, analyzes and manipulates transactional data using system-generated spreadsheets to identify suspicious activity.

Determine the appropriate course of action for adjudication, including but not limited to, closing the alert, creating a case for further investigation, flagging the customer for EDD Review, and/or, filing a Suspicious Activity Report with FinCEN

Work on engagements related to Office of Foreign Assets Control (OFAC), USA PATRIOT Act, Bank Secrecy Act (BSA), Know Your Client (KYC), and all other laws,

Manage assigned tasks related to drafting case investigations, preparing Suspicious Activity Reports (SARs), analyzing/utilizing Currency Transaction Reports (CTRs) and referencing Customer Identification Programs (CIPs).

Prepare well-written Suspicious Activity Reports (SARs) on suspect transactions.

Investigates to prevent payment of fraudulent claims committed by insured's, providers, claimants, etc..

Documents all appropriate case activity in case tracking system.

Utilize the U.S. Patriot Act, Bank Secrecy Act, AML and OFAC laws as a guideline for carrying out investigations on individual and company accounts

Identifies business customers who may be eligible for CTR reporting exemptions and refers the customer to the EVP KYC Director for evaluation

Makes referrals, both internal and external, in the required timeframe.

Facilitates the recovery of company and customer money lost as a result of fraud matters.

Assists team in identifying resources and best course of action on investigations.

Cooperates with federal, state, and local law enforcement agencies in the investigation and prosecution of healthcare fraud and abuse matters.

Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings

Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse.

Perform and present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government

EDUCATION:

High School Diploma St. Peters College 2005 to 2011 Bachelor of Science Anesthesiology Richmond Gabriel University; Certificate April 2023 2015 to 2022 CERTIFICATE:

Certified HIPAA Professional (CHP) Basic Life Support (BLS) Certified Information Privacy Professional/Europe (CIPP/E) Certified Community Service Worker First Aid CPR Certified Pediatric Advance Life Support (PALS) REFRENCES:

AT Lisa Bright University of Illinois Chicago adue77@r.postjobfree.com RN Candice Peyton Union Rep Mercy Hospital & Medical Center adue77@r.postjobfree.com Dr. Cyril Komadina Mount Sinai Hospital Chicago IL adue77@r.postjobfree.com COMMUNITY SERVICE:

Volunteer Nursing Assistant- Mercy Hospital & Medical Center 03/2019 to 02/2020 Observe patient’s physical conditions, document all changes and physical symptoms Monitored patient records to ensure that all medications were administered on time according to instructions.

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