Alannah Samuel
Taylors
Summary
Quality Assurance and Customer Experience Professional with over 10 years in healthcare call centers, claims processing, and patient advocacy. Expertise in evaluating interactions, ensuring compliance, and identifying process improvements. Committed to achieving quality and customer satisfaction goals in high-volume environments. Pursuing a Bachelor of Science in Psychology, expected graduation February 2027.
Overview
11
11
years of professional experience
Work History
Quality Assurance Analyst | Quality Assurance Specialist | Customer Experience Quality Analyst
CareNet
01.2023 - Current
- Met and consistently exceeded quality assurance, productivity, and customer satisfaction goals in a high-volume call center environment.
- Demonstrated adherence to call scripts, workflows, and regulatory requirements while maintaining exceptional customer service.
- Reviewed documentation for accuracy, ensuring compliance with organizational standards and facilitating quality assurance processes.
- Maintained compliance with HIPAA, company policies, and quality assurance standards during all patient interactions.
- Identified trends and opportunities for process improvement, enhancing patient experience and supporting operational efficiency.
- Collaborated with supervisors and clinical staff to resolve complex patient concerns, improving service quality and fostering teamwork.
- Served as a resource for peers by reinforcing quality standards and best practices.
- Provided accurate documentation in EMR/EHR systems while maintaining strict confidentiality.
- Worked remotely to support team operations
Patient Financial Solutions Specialist/ Quality Assurance
Accredo Pharmacy
10.2021 - 01.2023
- Maintained exceptional quality standards while processing high-volume healthcare claims.
- Ensured quality standards while processing high-volume healthcare claims, contributing to overall compliance and accuracy.
- Identified errors and inconsistencies, helping reduce processing delays and improve first-pass accuracy.
- Contributed to quality improvement initiatives that enhanced workflow efficiency and elevated customer satisfaction.
- Trained and mentored new employees on quality expectations, compliance requirements, and best practices.
- Worked with leadership to resolve complex claims, enhancing operational performance and streamlining processes.
- Ensured compliance with HIPAA, company policies, and healthcare regulations.
- Worked remotely to support team operations and communication.
Member Advocate
Disabled Veteran Solutions
01.2016 - 06.2021
- Provided exceptional customer service by effectively resolving member concerns, enhancing member satisfaction.
- Investigated and resolved escalated issues while maintaining quality standards.
- Reviewed member accounts for accuracy and compliance.
- Informed members about benefits, eligibility, and available resources, empowering them to make informed decisions.
- Coordinated with departments to streamline service delivery and enhance overall customer satisfaction.
- Maintained detailed and accurate documentation on every interaction.
Education
Bachelor of Science - Psychology
South College
Knoxville02-2027
Skills
- Quality Assurance
- Quality Auditing
- Call monitoring
- Quality Scorecards
- Root Cause Analysis
- Process Improvement
- Performance Metrics (KPIs)
- HIPAA Compliance
- Regulatory Compliance
- Customer Experience (CX)
- Data Analysis
- Microsoft Office Suite
- Electronic Medical Records (EMR/EHR)
- Performance Coaching
- Training & Mentoring
- Training & mentoring
- Quality control
- Data analytics
- Mentoring
- Call evaluation
- Group training
- Data analysis
Timeline
Quality Assurance Analyst | Quality Assurance Specialist | Customer Experience Quality Analyst
CareNet
01.2023 - Current
Patient Financial Solutions Specialist/ Quality Assurance
Accredo Pharmacy
10.2021 - 01.2023
Member Advocate
Disabled Veteran Solutions
01.2016 - 06.2021
Bachelor of Science - Psychology
South College