Client Relationship Management - Document Analyst

GERARD DICKINSON

Senior Claims Specialist Compliance & Regulatory Auditor

Based in Los Angeles County, CA Open to Relocation & Remote • **********@***.*** • 323-***-**** • linkedin.com/in/gerard-dickinson COMPLIANCE & CLAIMS LEADERSHIP SUMMARY

Senior Claims Specialist Compliance & Regulatory Auditor with a data-driven background across Telecenter, remote, and field-based environments. Built on a strong foundation of customer communication, rapid data interpretation, regulatory reporting, and policy adherence, supporting Claimants, Business Owners, and Executive-Level Management while ensuring risk mitigation and operational compliance.

Demonstrated expertise in Program Eligibility, Benefits Adjudication, Contract Interpretation, and Compliance Analysis, supported by extensive customer-facing experience including 5 to 8 stakeholder presentations per month. Proven capacity to manage 300+ daily tele-claims with accuracy, empathy, and alignment to corporate governance and regulatory standards. Achieved measurable 1.0–6.2% productivity and revenue gains through risk management, team training, quality assurance, and IT/OT collaboration. Holds a B.A. in Business Administration and is bilingual (Spanish), enabling effective communication with diverse populations. CORE COMPETENCIES

• Regulatory Auditing

• Benefits Eligibility Processing & Claims Adjudication

• Corporate Governance & Data Analytics Fraud Detection & Prevention Risk Assessment & Mitigation

• Variance, Trend & Data Analysis; Healthcare & Financial Claims Review Process Improvement & Workflow Optimization

• Quality Assurance & Internal Controls Policy & Procedure Development Contract Interpretation & Documentation Review PROFESSIONAL CERTIFICATIONS

• Google/Coursera Data Analytics Certificate (6 certifications: Data Cleaning, SQL, Python, Tableau, R) - 2026

• Cal Bright College - Data Science Certificate - 2025

• SEIU Local 1000 Union - Leadership Apprentice Steward Program - 2020

• OSHA 10-Hour Construction Safety License #21191613 - 2017

• CCAD - Training Certificate - 2016

CAREER EXPERIENCE

AllStem Staffing Southern California Edison — Pasadena, CAOct 2025 - Sept 2026 Benefits Claims Data Analyst — Financial & Healthcare

• Processed full-cycle claimant intakes and audited financial & medical documents for compliance with healthcare, insurance, and Medicare CMS standards, interpreting Explanation of Benefits (EOBs) for wildfire victims.

• Updated documentation, flowcharts, and procedures to address process gaps, leveraging CRM, KYC, CIP, and GRC systems for structured data reporting.

• Tele-call center and customer-facing role: processed and analyzed 9,000+ resident claims related to the Eaton Wildfire; customer service.

• Applied data analytics and trend modeling to identify claim patterns, improving processing efficiency and claimant experience.

• Achieved an 85% conversion rate on inactive wildfire claims through data-driven workflow optimization.

• Utilized CRM, KYC, CIP, GRC, and IT/OT collaboration tools (Excel, Teams, Adobe, Outlook) to enhance structured data reporting.

Creative Employment Services — Downey, CA Feb 2025 - Jul 2025 Field Supervisor Medical Claims Analyst

• Delivered patient presentations connecting outcomes to program effectiveness via in-person, Zoom & inbound calls.

• Conducted patient presentations linking outcomes to program effectiveness, in person, zoom and via inbound calls.

• Coached and supervised 7 staff on pipeline management, compliance, safety, and care protocols for individuals with disabilities, ensuring adherence to healthcare and workplace standards.

• Partnered and supported community outreach programs with city and regional agencies to align healthcare data reporting with compliance standards, applying Medicare CMS expertise.

• Managed and analyzed data collection and reporting systems for reintegration, medical support, and special needs programs to enhance overall program performance.

• Streamlined data accuracy and reporting efficiency using IT/OT tools, including Slack, Excel, Teams, Adobe, Word, and Outlook.

Northwest Administrators — Pasadena, CA Apr 2023 - Feb 2025 Compliance & Regulatory Auditor Pension & Healthcare

• Conducted 66+ internal and external audits of corporate payroll and pension contributions for healthcare and union benefit plans, ensuring compliance and accuracy.

• Telecenter and customer-facing executive role: managed inbound and outbound calls, achieving 2.6%–6.2% above productivity benchmark.

• Performed data validation and variance analysis to identify and resolve discrepancies in pension and pension contributions, enhancing financial integrity via Regulatory audit software.

• Delivered quantitative audit reports, workflow optimization, and corrective recommendations to senior HR leadership.

• Recovered $1M+ in penalty fees for Teamsters employees through analytical review of contribution data.

• Utilized Excel, Pivot Tables, SQL, and GRC systems to streamline audit processes and increase overall productivity. R.C.D. Estates — Palmdale, CA Sep 2022 - Present

Owner Sole Proprietor

• Managed a Section 8 housing portfolio under LACDA (Los Angeles County Development Authority) compliance standards and revenue forecasting.

• Processed housing applications, data audits and claimant eligibility reviews to ensure adherence to housing and health regulations.

• Analyzed; financial and medical documents, analytics to optimize rental operations and maintain regulatory compliance.

• Collaborated with county housing authorities to align reporting with public health and safety requirements.

• Leveraged data-driven insights to support sustainable housing development and community health initiatives. Acosta LLC — Palmdale, CA Sep 2022 - Apr 2023

West Coast Territory Sales Manager

• Managed 350 B2B accounts, achieving 2.3% market penetration in 6 months in a contract/travel-intensive role.

• Coordinated end-to-end sales, customer service, logistics, cash controls, inventory management, and compliance with PHI/PII regulations.

• Ensured operational accuracy and regulatory adherence in B2B sales and customer service.

• Trained new sales associates on product knowledge, merchandising, and strategic selling techniques; utilized Salesforce, CRM, Excel, and Teams.

State of California (EDD) — San Diego, CA Jun 2020 - Sep 2022 Claims Specialist Data Analyst Auditor

• Processed benefits, adjudicated claims, and managed team in tele-remote call center, reviewed 300+ claims daily ensuring compliance with state and federal policies.

• Supported IT fraud detection audits using identity verification, pattern analysis, real-time data tracking and compliance reporting, quality assurance review while adjudicating benefits.

• Applied knowledge of medical terminology, Medicare CMS guidelines, and government healthcare program administration to ensure accurate claims processing and regulatory compliance.

• Trained remote staff on new COVID-19 policies and customer service updates via Microsoft Teams, ensuring adherence to evolving state and federal compliance standards.

• Utilized CRM, KYC, CIP, GRC, and IT/OT collaboration tools (Excel, Teams, Adobe, Outlook) to enhance structured data reporting.

ADDITIONAL CAREER EXPERIENCE (2001-2020)

Bank of America (Tele-Call Center) • Hilti (Field) • Wells Fargo (Retail) • LA Federal Credit Union (Retail) • Accountabilities Professional Group (Temp Agency) • U-Save Car Rental (Retail/Field) • Hertz (Retail/Field) • Robert Half (Temp Agency) EDUCATION

B.A., Business Administration & Liberal Arts (Languages: Spanish, French) — Loyola Marymount University, 2001 PROFESSIONAL ORGANIZATIONS & VOLUNTEERISM

• SEIU Local 1000 — Workplace Advocate, 2020-2022

• Kabbalah Center — Congregant, 2010-2020

• Toastmasters International, 2026

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