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Click here or scroll down to respond to this candidateCandidate's Name
Street Address , SC (US)PHONE NUMBER AVAILABLEEMAIL AVAILABLEPROFESSIONAL SUMMARYSkilled in navigating complex healthcare systemsinsurance policiesand financial assistance programs. Proficient at providing compassionate guidance resolving issuesand educating patients on coverage options. Adept at conducting thorough assessments to determine eligibility and securing necessary resources for veterans. Strong communicator and problem solver expert at collaborating with healthcare providers and insurance agencies to achieve favorable outcomes for patients. AREAS OF EXPERTISE Quality Assurance Multitasking Complex Problem Resolution Cross- Functional Collaboration Customer Service & Retention Strategic Planning & implementation Proficient in MS OfficeExceland Windows Continuous Process Optimization Safeguarding confidential PHI(HIPAA) EXPERIENCESenior Quality Assurance Analyst, BlueCross BlueShield Of SC Performs quality control audits to evaluate accuracy and effectiveness of departmental operations functions including but not limited to claims membership customer service/call center workflow processing support systems procedures documentation etc. Identifies problems2013 - Present analyzes cause and effect and makes recommendations for improvements. Conducts focused quality audits across various operations functions to ensure quality standards procedures and methodologies are being followed. Documents findings of analysis and prepares recommendations for implantation of new systems procedures or organizational changes to reduce errors. Proficiency with BCBSSC/subsidiary systems. DB2 SQL or related Identifies areas of weakness and communicates recommendations on changes and improvements to training materials. Provides feedback to management on errors detected ensures errors are resolved and provides long-range solutions to causes. Develops and implements a quality control and improvement program based on targets identified through the quality reviews. Monitors and evaluates the implementation of corrective action plans. Compiles data provides feedback and generates reports for operations and/or training areas on quality performance. Trains new employees and remains current with all guideline changes work instructions etc. Writes or assists in writing desk procedures and training materials for departments.Hazard Insurance Processor, Assurant/Olsten Assurant/Olsten Performs a proactive approach to insurance processing and auditing in the mortgage industry identifying potential issues through critical thinking and meticulous attention to detail. Engaged in effective problem-solving through inbound and outbound calls to ensure active coverage ensuring accuracy and compliance. Collaborated effectively on team projects contributing problem-solving skills to address complex tasks within specified timeliness. Employed strategic critical thinking in the assessment of insurance for mortgage loans meticulously conducted audits of homes and loans to proactively identify potential issues.2011 - 2013Data Entry Specialist, Assurant/Olsten Ladder/Olsten Implemented proactive problem-solving strategies through precise document filing and scanning2008 - 2010 identifying and resolving potential issues to enhance the efficiency of departmental processes. Engaged in collaborative efforts with teams employing critical thinking skills to discern and propose enhancements for streaming administrative tasks thereby elevating operational efficiency.EDUCATIONBachelor of Art:Business Administration Strayer University,PresentHigh School Diploma Wilson High School, Florence, SC2002administrative tasksassessmentsattention to detail.auditingauditsSKILLSExperiencedExperiencedExperiencedExperiencedExperiencedEnglishLANGUAGESCERTIFICATIONS HIPAA |
