Amy Abrams
Lumberton,NC
Summary
Knowledgeable Quality Improvement Specialist passionate about maximizing patient care standards in Managed Care environments. Mentally sharp professional with 20+ years of behavioral healthcare experience.
Overview
22
22
years of professional experience
Work History
Quality Improvement Specialist
Eastpointe Human Services
04.2018 - Current
- Conducted audits of a variety of Managed Care processes, including Claims, Care Coordination, Call Centers, and Provider Network, ensuring adherence to quality standards and regulations.
- Collaborated with cross-functional teams to identify opportunities for continuous improvement.
Data Analyst
Eastpointe Human Services
12.2014 - 03.2018
- Enhanced business efficiency by identifying trends and patterns in complex datasets.
- Streamlined data processing for faster results by implementing advanced analytics tools.
- Improved decision-making processes with accurate data analysis and visualization techniques.
- Collaborated with cross-functional teams to ensure data integrity and accuracy, resulting in better-informed decisions.
Claims Quality Analyst
Eastpointe Human Services
01.2013 - 11.2014
- Developed and implemented claims auditing process.
IPRS Funding Specialist
Eastpointe Human Services
07.2012 - 12.2012
- Processing and Review of invoices for State and County Funding.
- Tracking expenditures of State and County Funded services against approved budgets.
Reimbursement Officer I
Southeastern Regional Mental Health, DD/SAS
08.2007 - 06.2012
- Supervised, directed and evaluated staff members of Reimbursement Department
- Improved overall department efficiency by streamlining processes and implementing new policies.
- Enhanced communication between provider network by organizing regular meetings and fostering open dialogue.
Administrative Assistant
University Of North Carolina At Pembroke
01.2007 - 06.2007
- Enhanced office efficiency by streamlining administrative processes and implementing organizational systems.
- Supported executive staff through scheduling meetings, coordinating travel arrangements, and preparing crucial documents.
- Ensured accurate record-keeping with diligent data entry and database management for Sponsored Research and Programs Department.
Patient Relations Rep IV - V
Southeastern Regional Mental Health, DD/SAS
07.2002 - 01.2007
- Processing remittance advice.
- Researching and correcting denied claims.
- Data entry and submission of IPRS member target population/eligibility data.
Education
Bachelor of Science - Business Administration
University of North Carolina At Pembroke
Pembroke, NCAssociate of Science - Office Systems Technology
Robeson Community College
Lumberton, NCSkills
- Decision Making
- Problem Solving
- Attention to Detail
- Cross-functional Collaboration
- Process Improvement/Process Mapping
- Auditing Techniques
- Adaptability
- Data Analysis
Timeline
Quality Improvement Specialist
Eastpointe Human Services
04.2018 - Current
Data Analyst
Eastpointe Human Services
12.2014 - 03.2018
Claims Quality Analyst
Eastpointe Human Services
01.2013 - 11.2014
IPRS Funding Specialist
Eastpointe Human Services
07.2012 - 12.2012
Reimbursement Officer I
Southeastern Regional Mental Health, DD/SAS
08.2007 - 06.2012
Administrative Assistant
University Of North Carolina At Pembroke
01.2007 - 06.2007
Patient Relations Rep IV - V
Southeastern Regional Mental Health, DD/SAS
07.2002 - 01.2007
Bachelor of Science - Business Administration
University of North Carolina At Pembroke
Associate of Science - Office Systems Technology
Robeson Community College
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