Mariah Kelley

Lead quality assurance initiatives across enterprise insurance platforms supporting multi-release production cycles each quarter.

Key Contributions & Impact:

• Developed and executed 150+ detailed test cases per release cycle to validate functionality, performance, and regulatory compliance.
• Managed 200+ defects annually, partnering with development teams to reduce resolution turnaround time by 25%.
• Standardized QA documentation libraries, improving testing efficiency by 20% and increasing release consistency.
• Conducted root cause analysis on recurring production issues, identifying process gaps and contributing to long-term system enhancements.
• Participated in Agile/Scrum ceremonies including sprint planning, backlog grooming, and retrospectives to ensure alignment between QA and development teams.
• Mentored junior QA analysts and provided performance feedback to strengthen team capability and quality output.
• Supported compliance validation efforts aligned with internal policies and regulatory standards.

Promotion earned in March 2025 in recognition of leadership, technical contribution, and sustained quality performance.

Supported HEDIS measure performance and regulatory compliance initiatives across Medicare and Medicaid populations.

Key Contributions:

• Reviewed and abstracted 80–100+ medical records weekly to support accurate HEDIS reporting.
• Conducted provider outreach to close care gaps, improving documentation retrieval and compliance rates.
• Performed QA review of chart abstractions to ensure CMS guideline adherence.
• Maintained strict regulatory compliance across Medicare and Medicaid quality measures.

Managed complex healthcare operations including claims processing, enrollment updates, and compliance validation.

Key Contributions:

• Processed Medicare enrollments and policy updates in accordance with federal regulations.
• Identified potential fraud indicators and escalated cases for investigation.
• Developed training materials for new representatives to improve onboarding efficiency.
• Evaluated operational workflows and recommended process improvements to enhance accuracy and turnaround time.

Administered eligibility determinations and application processing for government healthcare programs.

Key Contributions:

• Reviewed and processed applications for state and federal health programs.
• Conducted eligibility interviews and ensured documentation accuracy.
• Maintained HIPAA compliance and adherence to state regulatory requirements.
• Resolved escalated cases requiring detailed documentation review and cross-agency coordination.