Quality Assurance Auditor Resume Example
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QUALITY ASSURANCE AUDITOR
Professional Summary
To pursue a position that is both challenging and rewarding while offering stability, potential for growthand utilizes my skills and experience to their maximum potentital. Skills
Computer proficientCollaborativeExcellent communicator both verbal andAdaptablewrittenStrong work ethicAnalytical thinkerExercises good judgment
Quality improvement competencyStrategic planning capabilityPromotes positive behaviorEffective trainer
Skills
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Work History
Quality Assurance Auditor02/2014
Company Name – City, State
Company Name – City, State
- Routinely collaborated with department managers to correct problems and improve processes.Run and review reports for various departments.Conduct comprehensive monthly compliance audits to identify trending errors.Identify trending errors and make suggestions for corrective action.
- Tracked complaints and other customer inquiries.Routinely make corrections or suggestions for updating manuals and ensuring that informationalchanges are properly presented to the appropriate staff.Participated with committee that strives to keep staff engaged and involved with the company.Often take on new tasks within other departments to expand my current knowledge of processes.
- within the company.
Medicare Contractor10/2013
to 12/2013
Company Name – City, State
Company Name – City, State
- Review member account to determine accuracy and possible revisions to financial standing withcompany.
- Update system to reflect next year insurance changes.Work with all areas within department to ensure identified issues are resolved timely and staff has been properly educated on problems.
- Multitasking work by helping out with any area within department which is seeking assistance.
- Prioritizing projects as they are assigned.
Supervisor07/2012
to 10/2013
Company Name – City, State
Company Name – City, State
- Supervise 9-20 team members.Responsible for managing inventory and workflow.
- Interviewing & hiring potential job candidates as well as temporary staff during open enrollment period.
- Identifying training gaps for staff and work with training department on developing training programsthat would be most beneficial to staff and the corporation.Maintaining clear communication between departments for optimal flow of information.
- Perform annual performance assessment of staff.Continuously work toward identifying and removing barriers to increased productivity, quality, costeffectiveness, timeliness of operations, and customer satisfaction.
- Worked on personal development for staff.
- Skillfully developed departmental goals, objectives, standards of performance, policies and procedures.Consistently complied with applicable laws and regulations and ensured department adhered to Medicare regulations.
- Encouraged creative thinking, problem solving, and empowerment as part of the managements goals to improve morale and teamwork.
Medicare Credit & Collections Coordinator01/2010
to 07/2012
Company Name – City, State
Company Name – City, State
- Planned and executed Credit and collection program in accordance with Medicare guidelines.Created daily reports using multiple databases to track and send out letters to delinquent members.
- Managed member records so information is complete and accurate.
- Developed training to assist with implementing new program.
Resolution Examiner10/2007
to 01/2010
Company Name – City, State
Company Name – City, State
- Solved complex billing issues and helped resolve system issues.
- Maintained monthly records for programs that work in conjunction with Social Security, EPIC,Medicare and Medicaid.
- Prepared monthly, quarterly and yearly reports of reconciliation activity including financial impact to.
- the Plan.
M&B Processor Univera Healthcare01/2006
to 10/2007
Company Name – City, State
Company Name – City, State
- Responsible for processing applications Researched and resolved billing issues.Provided customer support for members.
- Worked with other departments in order to improve quality of work.Used Medicare guidelines for adjustments of member accounts.
Call Center Representative03/2005
to 07/2006
Company Name – City, State
Company Name – City, State
- Responsible for providing customer service and support to all Lifetime Heath Centers.
- Answered telephones & routed information to appropriate areas.
- Knowledge of referrals and department responsibilities as well as HIPPA regulations.
Patient Service Representative10/2004
to 03/2008
Company Name – City, State
Company Name – City, State
- Responsible for direct patient contact.Scheduling of appointments and streamlining information to other providers and departments.Ordering supplies.
- Maintained communication between staff.
Education
BBA: Business Administration2007Buffalo State College-
City
- Coursework in Business Administration
Skills
billing, creative thinking, Credit, customer satisfaction, customer service, customer support, databases, financial, hiring, insurance, inventory, letters, managing, Multitasking, next, policies, problem solving, processes, quality, Scheduling, teamwork, telephones, training
programs, workflow
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Resume Overview
School Attended
- Buffalo State College
Job Titles Held:
- Quality Assurance Auditor
- Medicare Contractor
- Supervisor
- Medicare Credit & Collections Coordinator
- Resolution Examiner
- M&B Processor Univera Healthcare
- Call Center Representative
- Patient Service Representative
Degrees
- BBA : Business Administration 2007
