Results-driven QA Specialist with over 3 years at ERP Consultant's, excelling in claims processing and insurance verification. Proven expertise in quality assurance and compliance auditing, utilizing advanced Excel for data analysis. Recognized for meticulous attention to detail and effective problem-solving skills, ensuring accuracy in documentation and adherence to health care standards. Methodical QA Specialist known for high productivity and efficient task completion. Specialized in automated testing, performance analysis, and defect tracking to ensure software quality and user satisfaction. Excel in problem-solving, communication, and adaptability, leveraging these soft skills to navigate complex projects and enhance team collaboration. Experienced in the field of medical claims management. Possess thorough understanding and knowledge of health insurance policies, coding, billing procedures and compliance regulations. Strengths include efficiency in reviewing, analyzing and managing medical claims with accuracy. Notable impact made by reducing errors, streamlining processes and improving overall operational efficiency at previous employment.
• Productivity benchmarks for daily claim reviews and account follow-ups.
• Compliance with payer and hospital billing policies.
• Microsoft Excel – Used for tracking claims, financial reconciliation, and data analysis.
• VMware & Remote Access Software – Used for troubleshooting and working in virtual environments.
• POS Systems and Accounting Software – Used for processing payments and managing account receivables.