Attica Meade
Silver Spring,Md.
Summary
Skilled professional with experience in both the medical and call center industries. Exceptional communication and Quality monitoring skills. Responsible for as many as two hundred audits per month. In depth knowledge and work experience with various computer software application and other technical and office equipment. Proficient typist and numerical & alpha key stroke operator. Experience working in fast paced environments where accuracy and confidentiality were necessary. Proficient Quality Analyst with experience handling and resolving critical quality problems using research abilities. Strong analytical, organizational and planning abilities. Consistently works with minimum supervision. Independent and self-directed. Detail-oriented professional committed to improving organizational outcomes by monitoring performance initiatives. Focused on planning, implementing, and optimizing procedures. Specializing in operations and dedicated to maximizing quality.
Overview
8
8
years of professional experience
Work History
Quality Analyst
Cognizant
10.2023 - Current
- Monitor program quality through surveys, interviews, focus groups, case studies, dashboards, scorecards
- As a Quality Analyst I ensure products meet established quality standards and industry benchmarks
- Collaboration: Work with development teams, product management, and customer support to understand product specifications, user needs, and address issues
- Monitor, Analyze, Measure, Interpret and deliver Cognizant data to Lumeris Operations
- Attend weekly collaborations with other subject matter experts (I.E
- Tl's other Managers within the scope with Client attendance and other High Level Leadership Temas
- Support and provide Customer Service feedback by staying up to date with processes and procedures
- Monitor and Manage QC caseloads including standard and expedited cases to ensure timely submissions and meet client deadlines
- Audit products and processes to identify areas for improvement before goods reach consumers
- Design and implement tests to ensure a product meets quality standards
- This can include manual and automated testing, performance testing, and security testing
Customer Service Representative
Global Network
05.2023 - 10.2023
- Monitor recordings and review interactions between Customer Service agents and Patient to evaluate conversations, achieve quality assurance, and improve agent performance
- Monitor KPI metrics like average handle time, first call resolution (FCR), and many others
- Ensures clients, hospitals, Insurance carriers and patients receive accurate reimbursement for their claims
- Very detail-oriented and organized, to maintain accurate customer service records
- Verifying medication, verifying if prior auth is required and what we need from provider to initiate prior authorization
Customer Service Representative
Charlotte, NC
10.2019 - 01.2023
- Understand and strive to meet or exceed call center metrics while providing excellent and consistent customer service
- Extensive knowledge of different types of coverage and policies
- Excellent multitasking skills, with the ability to work on many projects at once
- Very detail-oriented and organized, to maintain accurate customer service records
- Update customer information in the organization's system and verify that existing information is accurate
- Responsible for verifying customers coverage, to ensure necessary procedures are covered by an individual's bill
Insurance Reimbursement Specialists
Huntersville, NC
10.2016 - 09.2019
- Review insurance claims and correspondences in the billing department
- Ensures clients, hospitals, Insurance carriers and patients receive accurate reimbursement for their claims
- Ability to process claims quickly and accurately and ensure there are no errors or issues in the claim
- Working knowledge of being an independent thinker who can deal with claim issues or customer inquiries on their own
- Expert in Medicare and Medicaid
- Ability to handle all denials of claims for reimbursement in a hospital setting
- (I.E
- Timely filing, coding, charge review, level of downgrades)
Healthcare Intake Specialist
Charlotte, NC
07.2016 - 11.2016
- Approves and denies prescriptions that come in thru skilled nursing facilities, hospitals, and Physician offices
- Verify all Medicare benefits thru CMS for qualified Members
- Reviews care utilization of long-term care nursing home, assisted living facility and home health
- Supplies Members with additional data as needed, including prior medical encounters/assessments, verification of demographics, verification of expected/needed home service, benefit coverage, etc
- Communicate with physicians, nurse practitioners, or physician assistant regarding appropriate orders needed to provide services being requested
- Expert in Medicare and Medicaid
Education
GED -
New Bedford Public Schools
New Bedford, MA06-1990
Skills
- Proficient user of Word, Excel, and PowerPoint
- Excellent communication skills
- Strong attention to detail
- Superior Interpersonal skills
- 45 WPM
- 30 years of medical and insurance fields
Timeline
Quality Analyst
Cognizant
10.2023 - Current
Customer Service Representative
Global Network
05.2023 - 10.2023
Customer Service Representative
10.2019 - 01.2023
Insurance Reimbursement Specialists
10.2016 - 09.2019
Healthcare Intake Specialist
07.2016 - 11.2016
GED -
New Bedford Public Schools
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