Open to opportunities

Phylecia Whitley

@phyleciawhitley

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Operations and compliance professional with 10+ years of experience.

United States

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What I'm looking for

I am seeking a role that allows me to leverage my analytical skills and compliance expertise while contributing to a collaborative team environment focused on quality and process improvement.

I am an operations and compliance professional with over 10 years of experience in regulated healthcare and multi-site retail environments. Currently, I serve as a Team Lead at OptumRx, where I review claims and billing documentation to ensure accuracy and compliance, significantly reducing denial risks while adhering to HIPAA regulations. My expertise lies in data reconciliation, audit reviews, and Excel-based reporting, where I consistently maintain a 98%+ quality assurance rating.

Throughout my career, I have demonstrated a commitment to process improvement and team collaboration. At Nordstrom Rack, I successfully managed a high-volume department, driving 10-15% year-over-year sales growth while ensuring operational control standards. My ability to train and develop teams has led to improved data accuracy and compliance adherence, making a tangible impact on the organizations I have been part of.

Experience

Work history, roles, and key accomplishments

Current

Team Lead, Compliance & Claims Review

Current

OptumRx

Feb 2021 - Present (4 years 5 months)

Reviewed claims and billing documentation to ensure accuracy and compliance, reducing denial risk and maintaining adherence to HIPAA regulations. Audited client and provider documents to confirm required data for durable medical equipment (DME) orders, preventing financial and operational discrepancies.

HIPAA)Audit Quality Control

Assistant Department Manager

Nordstrom Rack

Nov 2017 - Present (7 years 8 months)

Oversaw operations for a high-volume department, managing schedules for 25+ employees and ensuring policy compliance in daily activities. Performed shipment and inventory audits to identify and correct discrepancies between system records and physical stock, maintaining data integrity.

Operations Management performance reporting Quality Assurance Sales Growth

Store Manager

Journeys Shoes

Jul 2015 - Present (10 years)

Managed all operational functions, including hiring, training, inventory control, and compliance audits. Conducted frequent stock counts and variance investigations to align system data with actual inventory.

Operations Management Inventory Control Compliance Audits Process Improvement Vendor Relations

Lead Cashier & Visual Merchandiser

Forever 21

May 2014 - Present (11 years 2 months)

Reconciled cash drawers and monitored front-end transaction accuracy during opening and closing procedures. Assisted with floor set execution and pricing compliance to maintain adherence to corporate standards.

Visual Merchandising Record keeping