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Quality Assurance Analyst

Location:
Manvel, TX
Posted:
July 28, 2024

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Resume:

KAILA WILLIAMS

ad7lda@r.postjobfree.com 832-***-**** Rosharon, TX 77583 WWW: Bold Profile

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Dependable Team Lead serving diverse needs of patients through active communication and responsive engagement with healthcare services and policymakers. Skilled at analyzing case files and databases to speed up inquiry response times and guide information through appropriate personnel channels. Maintains highest standards of ethics, professionalism and regulatory compliance to ease common stressors and de-escalate potential conflicts. Experienced Senior Quality Assurance Analyst driven to help make NOD claims products meet tight standards for usability and performance. Prepared to leverage 2 years' experience to take on dynamic new position with room for growth and advancement. Report preparation

Complaint resolution

Insurance Verification

Insurance billing

Information Collection

Production Monitoring

Quality control

Key performance indicators

Account management

Mentoring and Training

Problem Solving

Improvement Recommendations

Audit Assistance

Quality Issue Identification

Attentive and Observant

Sr Quality Assurance Analyst Corebridge Financial - Houston, TX 04/2022 - Current Identified problematic areas deviated from quality standards and recommended corrective actions. Researched issues and implemented quality assurance plans to correct problems. Compiled data on quality issues and vulnerabilities and reported findings with suggestions for improvement. Coached and offered improvement insight to team of 6 employees, boosting efficiency in NOD Claims department.

Participated in creating company guidelines for moral, ethical and legal policies, integrating applicable law enforcement and health and safety considerations.

Patient Access Coordinator Texas Children's Hospital, TMC - Houston, TX 10/2014 - 10/2021 Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance.

Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.

Attended weekly facility meetings to discuss logistical issues and obtain updated procedural and insurance- related instructions.

Resolved patient financial problems with guidance from documented guidelines and procedures. Helped address client complaints through timely corrective actions and appropriate referrals. Kept current with literature and felid advancements to advocate to and for patients. Patient Access Specialist MD Anderson Cancer Hospital - Houston, TX 04/2003 - 06/2014 Summary

Skills

Experience

Identified insurance payment sources and listed payers in proper sequence to establish chain of payment. Contributed to reduction of accounts receivables by adhering to predetermined policies and procedures to recover amounts due from patients.

Performed patient pre-admission, admission, transfer and discharge activities. Team Coordinator UnitedHealth Group - Houston, TX 03/2000 - 04/2003 Built strong relationships with customers through positive attitude and attentive response. Managed team workload to reach production targets. Worked with customer service representatives to handle escalated customer issues. Delegated daily tasks, addressed employee questions, and resolved scheduling issues. Led team meetings each shift to discuss scheduling, production and maintenance needs. Supervised 8 co-workers.

James Madison High School HOUSTON, TX

High School Diploma

Supervised team of 8 staff members.

Collaborated with team of 12 in the development of customer service portal. Customer Service Training - 1 year

Education and Training

Accomplishments

Certifications



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