Eugenia Floyd

Served as a subject matter expert for compliance and privacy inquiries in RFPs and customer due diligence questionnaires, ensuring timely and accurate responses. Supported the Compliance Manager with program controls and content development for new policies and procedures.

Served as a subject matter expert for compliance and privacy inquiries in RFPs and customer due diligence questionnaires, ensuring timely and accurate responses. Supported the Compliance Manager with program-related controls and content development for new policies and procedures. Tracked and managed ongoing state and federal regulatory reporting, overseeing multiple projects related to compliance

Responded to inquiries from various stakeholders regarding claims payments and processed a variety of customer transactions. Determined benefit eligibility on suspended claims and identified system problems, recommending solutions.

Responded promptly and accurately to inquiries from various stakeholders regarding claims payments and processed a variety of customer transactions. Determined benefit eligibility on suspended claims, reviewing claims history to decide on payment or denial. Identified system problems, recommended solutions, and supported production claims work as needed.

Processed payroll inputs into ADP Workforce Now, including adjustments, corrections, and miscellaneous entries. Managed employee timecard review, auditing for compliance with timekeeping and absence policies, and resolving discrepancies. Responded to employee payroll and benefits inquiries with a focus on superior customer service, educating employees on various benefit programs.

Processed payroll inputs into ADP Workforce Now, including adjustments and corrections, and managed employee timecard review. Responded to employee payroll and benefits inquiries, focusing on superior customer service.

Audited professional claims using product knowledge and processed hospital inpatient and special provider claims. Analyzed claims with incorrect adjustment codes and diagnosis information, verifying adherence to current provider contracts.

Understood various contract payment structures and performed initial claim interpretation and adjudication. Conducted standard quality reviews/audits to measure compliance with published policies and identified and distributed errors to business partners.

Understood various contract payment structures related to program fee billing and administration code reimbursement, accessing client portals for claims retrieval and adjudication. Performed initial claim interpretation and tracked claim receipts daily. Conducted standard quality reviews/audits to measure compliance with published policies, identifying and distributing errors to business partners.

Developed, implemented, and performed compliance auditing, monitoring, and reporting activities to ensure adherence to federal, state, and local regulatory and contractual requirements. Generated and analyzed quality and compliance reports and dashboards to identify trends and improvement opportunities. Identified, investigated, and resolved compliance issues, developing corrective action plans to

Developed and performed compliance auditing, monitoring, and reporting activities to ensure adherence to regulatory and contractual requirements. Generated and analyzed quality and compliance reports, identifying trends and improvement opportunities.

Monitored and evaluated correspondence for deviations from organizational policies and standards, using a quality monitoring data management system. Implemented corrective/preventive actions and provided recommendations to improve processes.

Audited professional claims using product knowledge, including standard plan benefits and provider special instructions. Processed Hospital Inpatient claims with interim billing guidelines and Special provider claims using the beech street pricing website. Analyzed claims processed with incorrect adjustment codes and diagnosis information, verifying claims under current provider contracts and fee

Monitored and evaluated all correspondence for deviations from organizational policies and standards, using a quality monitoring data management system to track performance. Implemented CAPAs to prevent recurrences and provided verbal and written recommendations to Market Access Operations. Collected trends and analyzed data to provide feedback for process improvement and SLA adherence.

Maintained the Integrated Management System (IMS) to ensure compliance and efficient operations, reporting performance to Senior Management. Facilitated regulatory and customer audits, including prep, gap analysis, and follow-up on non-conformances.

Maintained the Integrated Management System (IMS) to ensure continuous improvements for compliance and efficient operations. Facilitated regulatory and customer audits, including prep, gap analysis, and follow-up on non-conformances. Identified opportunities for improvement, developed recommendations, and ensured adherence to procedures through reviews and internal audits.

Managed candidate onboarding, processing background checks, I9 appointments, and fingerprint clearances. Communicated with hiring managers throughout the onboarding process and ensured data integrity, accuracy, and SLA adherence. Conducted process reviews and suggested improvements, assisting in new hire training and running reports for SLA updates.

Managed candidate onboarding, including processing background checks, I9 appointments, and fingerprint clearances. Communicated with hiring managers and ensured data integrity, accuracy, and SLA adherence.

Assisted in developing processes for compliance initiatives and updated existing compliance policies and procedures. Monitored compliance with Medicaid state contracts and applicable federal and state laws, managing multiple priorities simultaneously.

Assisted in developing processes for compliance initiatives and updated existing compliance policies and procedures. Monitored the company's compliance with Medicaid state contracts and applicable federal and state laws. Managed multiple priorities simultaneously, consistently meeting deadlines and developing competencies to support operational departments.

Completed a Master of Business Administration with a focus on Human Resource Management. This program provided advanced knowledge in managing human capital and organizational development.

Earned a Bachelor of Arts degree in Literature. The curriculum focused on critical analysis, research, and written communication skills.