Cassandra Pressey
HOPKINSVILLE,KY
Summary
Experienced Claims Quality Auditor with over 10 years in remote claim auditing. Expertise in claim handling standards and regulatory compliance, with a focus on error identification and corrective actions. Proven track record in improving claim processes and enhancing accuracy through proactive audits and training initiatives, while effectively managing high call volumes and communication.
Overview
12
12
years of professional experience
Work History
Claims Quality Auditor
Telus Agriculture
Hopkinsville , Ky
05.2023 - Current
- Reviewed, evaluated, and adjusted claims to facilitate prompt payment and ensure alignment with contracts.
- Reviewed documentation for accuracy and completeness to ensure compliance during claims process.
- Detected claims data discrepancies and implemented corrective measures.
- Provided feedback on claims handling procedures to streamline operations and improve quality.
- Trained new auditors on quality standards and best practices in claims review.
- Prioritized VIP claims and workload to ensure claims are completed following timing guidelines.
Quality Unemployment Claims Auditor
Maximus
HOPKINSVILLE, KY
12.2021 - 05.2023
- Reviewed unemployment claims and documentation for accuracy and completeness following state guidelines.
- Analyzed claims processing errors, gleaning information to determine origin of issues and initiated corrective action.
- Facilitated meetings to review audit findings and implement corrective actions, driving compliance and quality standards.
- Developed training materials for staff related to proper handling of claims processing activities and conducted training meetings.
- Conducted interviews with personnel involved in claims processing activities as part of the audit process.
- Prioritized daily tasks to complete workloads within department's expected timeframe.
Quality Advisor
Kelly Services
HOPKINSVILLE, Ky
02.2015 - 09.2021
- Led meetings to analyze quality control findings and formulate improvement strategies.
- Evaluated calls and chats for accuracy and compliance with established guidelines.
- Created training materials to enhance staff understanding of quality assurance practices.
- Answered high volume of inbound calls and chats to resolve customer concerns.
Education
General Education Development Diploma
HOPKINSVILLE, KySkills
- Claims evaluation
- Data accuracy
- Customer service
- Effective communication
- Attention to detail
- Workload prioritization
- Documentation review
- Discrepancy resolution
- Quality assurance
Timeline
Claims Quality Auditor
Telus Agriculture
05.2023 - Current
Quality Unemployment Claims Auditor
Maximus
12.2021 - 05.2023
Quality Advisor
Kelly Services
02.2015 - 09.2021
General Education Development Diploma