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training and qa analyst resume example with 13 years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Professional Summary

Organized Patient Service Representative/Lead with 11 + years of experience in healthcare. Adept at patient advocacy and education with commitment to efficiency. Skilled at coordinating busy offices, managing and knowledgeable to all segments in the Navigation Center and maintaining professionalism in stressful situations.

Skills
  • Problem resolution
  • Complaint resolution
  • Medical terminology knowledge
  • Professional telephone demeanor
  • Multi-line phone talent
  • Medical office administration
  • Typing 40 wpm
  • Insurance claims
  • HIPAA Guidelines
  • Team Oversight
  • Experienced customer service and communication skills
  • Reliable
  • Documentation and reporting
  • Client Communication
  • Professional Telephone Voice
  • Spanish fluency
  • Verbal and written communication
  • Multitask
  • Ability to switch from one segment to another depending on call center needs
  • Assist and coach coworkers
Work History
Training and QA Analyst, 08/2021 - Current
Mednax Boynton Beach, FL,
  • Developed monthly, end-of-quarter and other statistical reports for leadership team and quality improvement programs.
  • Monitored inbound and outbound calls made by 60+ employees to provide constructive feedback.
  • Trained New Hires on all department protocol and workflows
  • Assisted in creating workflows for new queues
  • Assisted in pilot to create the Navigation Center in MemorialCare
  • Assisted in all training due to changes in protocols during Covid
  • Coached Navs in errors send by clinics
Lead Navigator, 11/2020 - 08/2021
MemorialCare Medical Group City, STATE,
  • Engaged in learning and development opportunities to promote continued performance improvement.
  • Learned and maintained in-depth understanding of new policies and changes, providing knowledgeable responses to diverse questions.
  • Cross-trained and provided back up for supervisors and assisted in trainings
  • Motivated employees to increase productivity and maximize service quality with hands on leadership training
  • Handled advanced issues with calm, knowledgeable and professional approach
  • Mantained and managed queues and floor support during the weekend, opening and closing shifts
  • Logged and reviewed Improvement Logs from the Clinics
  • Coached Navigators
  • Covered shift when needed
  • Assisted in training new Navigators
  • Assisted in reviewing huddles/refreshers with department
  • Promoted superior experience by addressing patient concerns, demonstrating empathy and resolving problems.
  • Responded proactively and positively to rapid change.
  • Mentored and guided Navigators to foster proper completion of assigned duties.
  • Completed projects that have been assigned while assisting with inbound and outbound calls in a timely manner for the medical group, customer service line, and specialty scheduling
  • Participate in meetings with management to build new workflows to improve the department
Patient Navigator 1, 02/2019 - 11/2020
Memorialcare Medical Group City, STATE,
  • Efficiently schedule doctor and healthcare appointments for our patients
  • I am proficient in the GNP line of business. I assist provider offices, health plans, and members with issue resolutions claims status calls, and referral management calls
  • Monitored Twistle. I would enroll patients to Twistle, identify an emergent situation and escalate it to a our TANs, and would communicate with our patients to ensure they were reporting their symptoms.
  • Adhered to company policies and scripts to consistently achieve call-time and quality standards.
  • Participated in regular team meetings, huddles, and quality improvement projects to improve patient care.
  • I am able to assist patients in navigating mychart and provide Mychart support
  • Help manage high call volume in a fast pace environment
  • Fluent Medical Terminology in English and spanish
  • Participate in continuous quality improvement process
  • Data entry
  • Proficient in Epic
  • Knowlegeable to all business segments
  • Assist in training and coaching new employees in all segment
  • Well-app
  • Nav Patient queue
  • Millers queue
  • Boeing queue
  • Excellent communication and customer service
  • Fast learner and Reliable
  • Self motivated
  • Team Player
  • Can take 90 + calls a day
Front Office Receptionist, 10/2008 - 02/2019
Pathway Medical Group City, STATE,
  • Managed master calendar and scheduled appointments for 4 providers based on optimal patient loads and clinician availability.
  • Organized paperwork such as charts and reports for office and patient needs.
  • Completed and filed financial documentation for accounting purposes.
  • Completed skilled administrative work to support all office staff and operational requirements.
  • Adeptly managed multi-line phone system and pleasantly greeted all patients.
  • Checked patient data including insurance, demographic and health history to keep information current.
  • Completed clerical duties and tasks for clinic administration.
  • Scheduled appointments for doctor visits and procedures using desktop calendar software.
  • Obtained payments from patients and scanned identification and insurance cards.
  • Used computer programs and registration systems to schedule patients for routine and complex procedures.
  • Kept waiting room neat and organized at all times.
  • Pull charts, file charts, and create charts
  • Take detail messages for the providers
  • Inform patients of test results, radiology and lab
  • Manage patient refill and prior authorizations for medication
  • Communicate with pharmacy for all member medication needs
  • Distribute incoming faxes
  • Contact other provider/specialist office for any patient needs
  • Retrieve and forward patient patient medical records following HIPAA guidelines
  • Manage online medication requests/escripts
  • Manage Home Health and DME orders and authorizations
  • Assist in filling forms for patients (EDD, FMLA, DMV Placard, IHSS, Medication Assistance program, etc)
  • One year experience in medical billing and coding
Education
High School Diploma: , Expected in 06/2005
-
Los Amigos High School - Fountain Valley, CA
GPA:
Status -
No Degree: Certified Medical FO Clerk/Insurance Verification, Expected in
-
Lincoln Adult Education Center - Garden Grove,
GPA:
Status -

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Resume Overview

School Attended

  • Los Amigos High School
  • Lincoln Adult Education Center

Job Titles Held:

  • Training and QA Analyst
  • Lead Navigator
  • Patient Navigator 1
  • Front Office Receptionist

Degrees

  • High School Diploma
  • No Degree

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