Data Entry Clerk Remote, Detail-Oriented Professional

Nayiba Vela

Sunrise, FL • Mobile: 305-***-**** • ***********@*****.***

LinkedIn: linkedin.com/in/nayiba-vela-a318b881

Professional Summary

Healthcare operations and insurance program professional with extensive experience supporting multi-state provider networks across risk management, insurance administration, credentialing, and revenue cycle performance. Proven ability to improve operational performance, streamline workflow efficiency, and implement automation to support insurance, verification, and credentialing operations. Experienced in insurance program administration, policy renewals, coverage coordination, KPI reporting, and cross-functional operations. Recognized for improving turnaround time, reducing escalations, and strengthening documentation accuracy across complex healthcare environments. Core Competencies & Technical Skills

Healthcare Operations • Insurance Program Administration • Policy Renewal Management • Insurance Coverage Administration • Broker Coordination • Exposure & Coverage Review • Premium Coordination • Workflow Optimization • Process Improvement • Operational Performance

• KPI & Performance Reporting • SLA & Turnaround Management • Provider Verification • Claims History Processing • Documentation Accuracy • Cross-Functional Coordination • Performance Metrics • Process Automation • Compliance Monitoring • Coverage Lifecycle Management • Multi- State Operations

Professional Experience

Manager – Insurance and Risk Management

Envision Healthcare Ft. Lauderdale, FL (Remote) January 2017 – Present

• Manage insurance operations supporting a multi-state provider network of 40,000+ clinicians, ensuring accurate insurance coverage, renewal readiness, and program effectiveness across enterprise insurance programs.

• Serve within the Insurance team overseeing enterprise policy renewals and insurance program administration. Manage renewals and ongoing coverage for Professional Liability, Cyber, Commercial General Liability, Workers Comp, Property, and Third-Party insurance programs outside the RRG structure, ensuring timely renewals, accurate documentation, and coordination with brokers and internal stakeholders.

• Coordinate closely with insurance brokers during the full renewal cycle, supporting data gathering, exposure review, underwriting submissions, and renewal preparation to ensure on-time policy placement and accurate coverage alignment.

• Support coverage review and exposure tracking, ensuring accurate provider data, risk information, and operational inputs are reflected in renewal and insurance program documentation.

• Assist with premium coordination and renewal readiness, ensuring broker deliverables and required information are completed in advance of renewal deadlines to maintain uninterrupted coverage.

• Oversee claims history verification operations averaging 1,500 files per month, ensuring documentation accuracy and consistent workflow execution.

• Lead and develop an offshore team of 4, providing training, workflow management, performance oversight, and quality control to improve productivity and processing accuracy.

• Reduced verification turnaround time from 3–4 business days to 24 hours by optimizing workflows and strengthening SOPs and quality controls.

• Reduced internal escalations by improving verification accuracy and redesigning operational workflows.

• Implemented structured metrics and KPI reporting, enabling offshore team to deliver performance data and operational insights to leadership.

• Led automation of the Certificate of Insurance (COI) renewal process using Origami Risk, enabling automated generation and distribution of renewal certificates.

• Improved insurance program renewal readiness by ensuring all broker deliverables completed one month prior to expiration, reducing last-minute risk exposure and improving operational planning.

• Automated Patient Compensation Fund tracking across IN, WI, KS, PA, LA, improving monitoring and operational efficiency.

• Identify workflow inefficiencies and implement process optimization and automation to improve operational performance. Malpractice Coordinator

Sheridan Healthcare Sunrise, FL (Remote) February 2015 – January 2017

• Managed high-volume Certificate of Insurance (COI) operations, processing daily requests from credentialing, operations, and medical staff offices while maintaining a 24-hour service-level turnaround.

• Coordinated nationwide annual insurance renewal distribution for 60,000 providers, overseeing issuance of 175,000 certificates company wide.

• Administered full COI lifecycle management, running active and terminated provider reports to determine issuance, updates, or cancellations.

• Served as liaison between Insurance & Risk Management and Credentialing, ensuring documentation accuracy and coverage alignment across multi-state operations.

Administrative Assistant to Senior Director & Credentialing Staff Sheridan Healthcare, Inc. Sunrise, FL February 2013 – February 2015

• Reported directly to the Director, providing day-to-day administrative and operational support to Credentialing Department staff and leadership.

• Managed department activities including calendar management, meeting coordination, scheduling, and documentation, ensuring smooth operations and timely follow-up.

• Coordinated credentialing workflows including onboarding and offboarding documentation for new and terminated credentialing staff, ensuring compliance with internal procedures.

• Assisted with departmental tracking, reporting, and cross-functional coordination supporting credentialing operations and staff management.

• Maintained confidential employee and departmental records in compliance with organizational standards.

• Supported workflow organization, data tracking, and internal communications to improve departmental efficiency. Senior Reimbursement Specialist – Revenue Cycle

Sheridan Healthcare, Inc. Sunrise, FL November 2006 – February 2013

• Managed full claims lifecycle including submission, payer follow-up, denial resolution, and reimbursement posting.

• Worked with Medicare, Medicaid, and commercial payers, ensuring billing accuracy and adherence to payer policies.

• Investigated and resolved complex denials, underpayments, and coding discrepancies to support reimbursement accuracy.

• Supported revenue integrity and billing accuracy across high-volume operations.

• Trained staff on revenue cycle workflows, denial management, and claim processing procedures.

• Collaborated with billing and operations teams to improve reimbursement workflows. Technology & Systems

• Microsoft Excel (Dashboards, KPI Reporting, Data Tracking) • Origami Risk • Oracle • eClinicalWorks (ECW) • AS400 • SMART • Vistar • Enworks • Microsoft Office Suite • MSOW • Evips • Oracle Education

• Healthcare Administration – Miami Dade College (In Progress)

• Florida Notary Public • Loan Signing Agent • Remote Online Notary (RON)

• Medical Billing & Coding – National School of Technology Additional Experience

Director of Operations – Tri-County Windows and Doors LLC Managed operations, vendor coordination, scheduling, and workflow efficiency. Operations & Purchasing Specialist – General Stair Corporation Supported purchasing, budgeting, vendor performance, and workflow improvement. Medical Scribe - ScribeAmerica

Document clinical encounters in EHR (eClinicalWorks), ensuring accurate, compliant documentation and supporting coding and billing accuracy.

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