Alyssa Jones
Regulatory Compliance
Columbus, GA,GA
Summary
Compliance Professional with 18 years of experience, seeking a position that will utilize expert knowledge of compliance processes and regulatory procedures, while building upon leadership skills in a support role to management
Overview
18
18
years of professional experience
Work History
Claims Lead Specialist, Unclaimed Property
Aflac-Individual Benefits Division
Columbus, GA
10.2020 - Current
- Leads daily activities of Claims Compliance's Unclaimed Property team of 11 Specialists
- Motivates, coaches, and develops individuals within team
- Ensures that quality and production goals are met
- Provides consistent and constructive feedback
- Identifies training needs for Research Specialists and Claims Specialists
- Bridge knowledge gaps
- Established Life quick reference guide for Claims Specialists
- Prepares monthly performance information for Management review
- Liaison between Actuarial Department and Unclaimed Property Team
- Effectively communicates with internal and external customers
- Current Subject Matter Expert for Regulatory Settlement Agreement and Global Resolution Agreement
- Currently Administrating Lost Policy Databases
Life & Accidental-Death Claims Specialist III
Aflac
Columbus, GA
10.2012 - 09.2020
- Reviewed Accidental-Death and Life claims in accordance with policy terms
- Prior to establishment of UCP team, identified Policyholders and proactively initiated claims subsequent quarterly Death Master File reporting
- Managed files which are now deemed “Catastrophic Events”
- Partnered with Legal Department and Medical Consultant for recommendations regarding complex files
- Demonstrated coaching abilities training newly promoted Specialists
- Participated in creation of current Life Claims Manual
- Collaborated with teammates to improve communication standards
- Subject Matter Expert-Life in Swiss RE documentation reduction effort
- Financial and Operational accuracy of 100%
Claims Specialist I-III Accident & Sickness
Aflac
Columbus, GA
04.2005 - 10.2012
- Assisted in development of key metrics database for pilot Escalation Team
- Subject Matter Expert in relation to illegible documentation
- Processed Accident, Vision Now and Disability files
- Later trained and processed in Hospital Indemnity, Intensive Care, Specified Health Event and Care Assist products
- Selected for Pilot team to oversee Incorrect Applications and complex files
- Maintained excellent production and 100% quality while providing exceptional customer service
Education
Associate of Science - Surgical Technology-Applied Health Sciences
01.2005
Skills
- Expert knowledge of Claims Analysis techniques
- Cross-functional team management
- Able to quickly analyze issues and formulate effective solutions
- Excellent written, verbal and interpersonal communication
- Proficient in Microsoft Office
- Technical Innovation Expertise
Certification
- Lean Six Sigma Yellow Belt
- Lean Six Sigma Green Belt
- LOMA- Associate Customer Service
- LOMA- Associate Life and Health Claims
- LOMA- Insurance Regulatory Compliance
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