Casandra Davison
Leland,NC
Summary
Detail-oriented Quality Assurance professional with extensive experience in dental claims processing, auditing, appeals management, and performance reporting. Proven ability to identify trends, collaborate with leadership, support process improvements, and maintain high accuracy standards across multiple lines of business. Recognized for reliability, analytical thinking, and cross-functional support.
Overview
25
25
years of professional experience
Work History
Quality Assurance Enablement Analyst
Delta Dental
Alpharetta, GA
12.2023 - Current
- Perform in-depth quality reviews of examiner-processed claims to ensure accuracy and compliance
- Partner directly with Claims Supervisors to communicate errors, trends, and corrective actions
- Track and report daily QA activity and outcomes using Excel-based reporting tools
- Manage appeals efficiently, providing detailed and actionable feedback
- Lead and contribute to departmental projects supporting quality and operational initiatives
- Performed Monthly Reports for Performance Management and Cash Receipts to communicate top trends for examiner errors and provide recommendations to reduce those trends
Quality Assurance Specialist
Delta Dental
Mechanicsburg, PA
07.2019 - 12.2023
- Conducted quality audits of examiner and system-generated claims across multiple processing categories
- Reviewed complex claims including Status H, Performance Management, TX ERS, Delta Care Encounters, and Post Pay
- Documented processing errors and coordinated corrections with leadership and examiners
- Served as a subject-matter resource for team members regarding claims and appeals
- Communicated findings and feedback to Claims Supervisors to support examiner development
- Reviewed ORL updates and provided feedback for system and process enhancements
- Prepared and distributed QA split-count and performance reports
- Maintained consistent performance against quality metrics over a rolling 12-month period
Claims Examiner I
Delta Dental
Mechanicsburg, PA
02.2016 - 07.2019
- Reviewed and processed dental claims in accordance with Delta Dental and group guidelines
- Ensured provider and claim information accuracy prior to adjudication
- Consistently met productivity and accuracy expectations in a high-volume environment
Customer Service Representative II
Delta Dental
Mechanicsburg, PA
10.2013 - 02.2016
- Assisted members and providers with benefits, claims inquiries, and issue resolution
- Researched claims to ensure accurate payment and processing
- Coordinated claim reprocessing and provider material requests
- Managed written correspondence with professionalism and attention to detail
Customer Service Representative I
Delta Dental
Mechanicsburg, PA
03.2013 - 10.2013
- Verified eligibility and explained benefit coverage to members and providers
- Provided claim status updates and plan information
- Processed requests for ID cards, EOBs, and related materials
Customer Service Representative
Aerotek
Harrisburg, PA
11.2012 - 03.2013
- Delivered customer service support related to eligibility, benefits, and claims
- Assisted members and providers in a fast-paced call center environment
Customer Relations Representative
AT&T Mobility
Harrisburg, PA
10.2004 - 10.2011
- Provided high-quality customer service for billing, account, and technical inquiries
- Entered and maintained accurate customer data
- Supported management with follow-ups and customer issue resolution
Enrollment Specialist
Coventry Health
Harrisburg, PA
11.2002 - 05.2003
- Assisted employers and employees with health insurance enrollment
- Reviewed enrollment documentation for accuracy and completeness
- Conducted outbound calls to resolve missing or incorrect information
Data Entry Clerk
Labor and Industry
Harrisburg, PA
08.2001 - 11.2001
- Entered and verified data with a high level of accuracy
- Utilized 10-key data entry systems
Education
Special Education
Harrisburg Area Community College
Harrisburg, PAHigh School Diploma - undefined
Central Dauphin East Senior High School
Harrisburg, PASkills
- Microsoft Word, Excel, PowerPoint, Teams
- Windows
- Citrix (Metavance, MACESS)
- Claims & QA Reporting
- Appeals Management
- Data Tracking & Analysis
- Team collaboration and leadership
- Documentation and reporting
- Attention to detail
- Project management
- Verbal and written communication
- Presentation building
- Problem-solving
- Excellent communication
- IQAD
- BI Dashboard
Timeline
Quality Assurance Enablement Analyst
Delta Dental
12.2023 - Current
Quality Assurance Specialist
Delta Dental
07.2019 - 12.2023
Claims Examiner I
Delta Dental
02.2016 - 07.2019
Customer Service Representative II
Delta Dental
10.2013 - 02.2016
Customer Service Representative I
Delta Dental
03.2013 - 10.2013
Customer Service Representative
Aerotek
11.2012 - 03.2013
Customer Relations Representative
AT&T Mobility
10.2004 - 10.2011
Enrollment Specialist
Coventry Health
11.2002 - 05.2003
Data Entry Clerk
Labor and Industry
08.2001 - 11.2001
High School Diploma - undefined
Central Dauphin East Senior High School
Special Education
Harrisburg Area Community College