Heavenly S.

Background

About Heavenly S.

I am a healthcare operations and compliance professional with hands-on experience supporting eligibility, regulatory compliance, audit readiness, and payer operations within large health insurance organizations.In my current role, I perform eligibility and coverage analysis to ensure compliance with plan rules, regulatory requirements, and internal quality controls. I investigate complex eligibility discrepancies impacting downstream claims processing, partner cross-functionally with Claims, Compliance, and Operations teams, and support audit readiness through documentation, issue tracking, and control adherence.My background spans healthcare operations, payer-provider interactions, claims analysis, and quality oversight, with a strong focus on identifying trends, mitigating risk, and improving operational and compliance outcomes. I bring a detail-oriented, analytical approach to regulatory review while maintaining efficiency in fast-paced, high-volume environments.I am seeking opportunities within healthcare compliance, audit, program integrity, or operations analytics where I can contribute to regulatory excellence, risk mitigation, and data-informed decision-making.