Raphael Wright Email & Phone Number

Columbia, Sc, Us

Columbia, South Carolina, United States

Columbia, South Carolina Metropolitan Area

Columbia, Sc

• Performed various USAA AML investigations, historic profile deviation, and compliance reviews in conjunction with countries and regions in relation to high-risk areas• Conducted assessments of transaction monitoring alerts, ensuring policies, procedures and regulatory compliance requirements are followed• Understood and executed predefined alert review procedures to complete review of assigned alerts while meeting quality standards• Conducted investigations of automated suspicious alert activity, documented narratives on investigative findings and ensured awareness for conclusions for proper escalation requirement and further action• Synthesized investigative findings into concise and factually accurate SARs• Participated in required AML and BSA trainings as assigned• Met production targets and quality standards with increasing expectations• Maintained a strong level of independence, organizational and time management skills with a high focus on attention to detail

Columbia, South Carolina, United States

• Review USAA loan documents for evidence of compliance with consumer protection guidelines and regulations• Work with subject matter experts to gain an overall understanding of regulatory requirements for each case• Train and communicate with analysts to identify and eliminate the risks of noncompliance for internal and external laws and regulations• Conduct regular audit analysis to identify potential weaknesses and noncompliance situations with accuracy• Work with management concerning the organization’s procedural documents to ensure all cases are complaint

Columbia, South Carolina

• Ensured compliance with established internal audit control procedures by examining records, reports, operating practices and documentation• Maintained internal control systems by updating audit programs; recommending new policies and procedures• Communicated audit findings by preparing final reports, collecting, analyzing and summarizing operating information and trends• Verified departmental standard operative procedures to ensure efficient process flows for all new business • User Acceptance Testing (UAT) of all carrier platforms to ensure agents ability to quote and bind policies are efficient for all new business • Created test plans and scripts for all Workers Comp, Premium and Customer Service Audits to ensure all exclusions and endorsement forms are attached to policy forms• Analyzed and construct carrier policies to ensure all pertinent documents are accurate prior to issuance

Columbia, South Carolina Area

• Ensured audit, performance and reporting deadlines are met by providing error reports to various business units• Functioned as the subject matter expert for team and auditors by assessing, monitoring and auditing daily processing transactions and operational functions• Oversee departmental controls and enhancements to ensure accordance with the Module Audit Rule (MAR) internal audit standards and guidelines• Developed and generates daily reports used to perform audits of daily transactions processed• Assisted leadership by creating and implementing policies and processing procedures for internal and external clients• Employed Lean Six Sigma Concepts to ensure effective process redesign improvement and implementation• Partnered with Process Improvement Council to identify trends and develop strategic planning methodologies to enhance workflow, procedures and overall business growth• Analyzed internal systems and platforms to support business process functions for effective testing and process implementation• Promoted customer satisfaction, both internal and external, through continuous quality assessments and improvements by providing verbal and non-verbal feedback• Trained and guides staff by developing internal processing procedures to assist with training and daily work processing• Vast knowledge of group insurance policies, underwriting guidelines and internal procedures for multiple lines of business• Provided verbal coaching to staff to better assist with report findings to ensure accuracy for internal and external clients

Columbia, South Carolina Area

• Managed group enrollment audits, processes and identified errors to ensure accuracy and punctuality for all groups• Managed claim audits and identified errors to ensure accuracy and punctuality for all claim benefits• Met with business unit leadership to discuss metrics and strategic planning for improving quality scores• Conducted monthly calibrations with external vendors to discuss audit findings, training and overall planning for improvement • Ensured that all Ad Hoc In Good Order Audit templates were used accordingly for claim notations• Retrieved query line of business percentage reports by means of Microsoft Access• Root Cause Analysis (RCA) executed recommendations to improve person (s) performance through changes in process flows, tools, case data collection and training• Evaluated business unit reports, provide necessary feedback and ensured all matters had satisfactory responses• Performed detailed analysis on various projects to support recommendations to multiple business units• Prepared weekly executive summaries for leadership to present accuracy and error findings for business units• Maintained an understanding of operations, SOPs process flow and reporting for all pertinent business units• Researched marketing materials, underwriting guidelines, enrollments and system entries for each enrollment audit• Developed quality solutions for leaders using project management (PDCA cycle), change management (ADKAR model) methodologies by conducting pre-audits through post-audit activities to assist leaders with achieving departmental, divisional and company goals• Worked extensively with network drives and systems such as Genelco, SharePoint, WorkDesk, Accurint, Workflow, Microsoft CRM, B-Prompt, Raosoft and Business Objects

• Worked extensively with network drives and systems such as Genelco, WorkDesk and Excel• Examined complex claims and certificates to determine insured’s coverage status• Organized, maintained and retrieved multiple detailed and electronic records stored within Wellness and Hospital Indemnity work sets• Made outbound calls to the insures and providers to obtain claim information• Authorized claim payment, setting reserves on payment and ensuring timely disbursement of funds to insureds and providers• Examined CPT and ICD-9 codes to ensure proper diagnosis for payable claims

Bachelor'S Degree, Political Science And Government

High School Diploma