Results-driven Workflow and Claims Quality Specialist with over 12 years of experience in managing high-volume digital queues and complex data adjudication. Skilled in navigating database software and ensuring HIPAA compliance and regulatory adherence. Acted as Subject Matter Expert to coach teams, resolve escalations, and uphold data integrity within strict production standards.
Work History
Senior IT Workflow Analyst
1 Year
Segra, (now Cox family of companies) | 08.2025 - Current
Adjudicated and monitored high-volume operational queues, identifying and triaging stalled customer service, financial, and records tasks to ensure compliance with operational guidelines.
Partner seamlessly with cross-functional teams to audit financial and data entries, check document accuracy, and implement quality-assurance measures to optimize processing throughput.
Author and maintain comprehensive Standard Operating Procedures (SOPs) and compliance guidelines to guarantee 100% data consistency across multiple enterprise markets.
Adjudicate and monitor high-volume operational queues, proactively identifying, triaging, and re-routing stalled customer service, financial, and records tasks to meet strict operational guidelines.
Conducted outbound communications with internal and external stakeholders to gather necessary information for timely account adjustments and resolution.
Senior Process Integration & Workflow Specialist
2 Years 5 Months
Segra, (now Cox family of companies) | 03.2023 - 08.2025
Ensured data integrity, record verification, and high-volume document indexing configurations for corporate accounts in a production-driven environment.
Analyzed routine operational trends and pipeline bottlenecks utilizing Microsoft Excel and Power BI to consistently meet and exceed performance metrics.
Developed and delivered comprehensive training modules for new software platforms and data entry mechanisms, enhancing team performance and technical proficiency.
Identified process gaps with project managers, engineering scalable, error-free operational improvements.
Sales Support Representative
1 Year 9 Months
Segra, (now Cox family of companies) | 06.2021 - 03.2023
Managed end-to-end processing pipelines, ensuring 100% accuracy and compliance of documentation prior to final handoff.
Acted as the reliable central point of contact for internal teams and customers, troubleshooting and resolving complex account discrepancies and records requests.
Processed rapid routing requests under tight timelines, achieving recognition in 2023 Presidents Club for operational accuracy and high-volume performance.
Billing & Customer Support Representative
8 Years 4 Months
Lumos Networks, (now Segra) | 02.2013 - 06.2021
Maintained exceptional retention in a high-volume support environment, addressing financial accounts, scheduling updates, and records changes.
Conducted document, record, and financial reviews to verify accuracy, check provider details, and maintain compliance with HIPAA data privacy standards.
Resolved service escalations and performed account rework and billing adjustments by efficiently navigating legacy database systems and ticket queues.
Education
AAS - Business Management
American National University | Charlottesville, VA | 05-2024
Dean's List 2024
AAS - Medical Office Specialist
American National University | Charlottesville, VA | 06-2014
Coursework includes: Medical Terminology, Records Management, HIPAA Compliance, Office Procedures.
Dean's List 2014
Diploma
Waynesboro High School | Waynesboro, VA | 01-2011
Skills
SLA compliance
Audit integrity
Record review
Process optimization
Data Entry Optimization
Productivity & Core Office: Advanced Excel
Microsoft Word
Data Auditing
PowerPoint.
CRM & Enterprise Platforms: Salesforce
ServiceNow
Microsoft Dynamics.
Metasolv
Cross-functional collaboration
Proprietary systems
Accomplishments
Financial Integrity: Identified $25k in missing revenue through detailed historical queue auditing and records verification.
Leadership Development: Selected for and graduated from the 2025 Segra Leadership Academy.
Performance Excellence: Awarded the 2023 Presidents Club Winner for maintaining flawless data accuracy in a high-production environment.