JASMINE MCGHEE
Buford,GA
Summary
Highly motivated and professional Quality Review Analyst with experience in identifying and resolving complex-quality issues. Proficient in analyzing data, providing high-level support, implementing effective solutions to improve processes, handling confidential documents, and ensuring compliance. Possess exceptional communication and interpersonal skills with a proven ability to work independently and as part of a team. Known for being a resourceful problem-solver with a keen eye for detail. Seeking an opportunity to leverage my expertise and contribute to the success of a company.
Overview
12
12
years of professional experience
Work History
Quality Review Analyst
Noridian Heathcare Solutions
06.2024 - Current
- Proactively identified potential issues within reviewed documents, reducing instances of oversights or inaccuracies.
- Monitor, document, and report on quality outcomes and ensure appropriate resolution.
- Increased the accuracy of risk assessments through rigorous data analysis and evaluation.
- Identified discrepancies in financial records, leading to improved internal controls.
- Participated in audits, ensuring compliance with industry regulations and standards.
- Maintain a confidential-level security clearance while working on critical quality review projects for government claims
- Coordinate and schedule meetings with team members for QA findings and evaluations
- Assist in the development, implementation, and evaluation of ongoing quality improvement processes
- Streamlined review processes for increased efficiency and productivity.
- Collaborated with cross-functional teams to ensure accurate reporting and analysis.
- Implemented new analytical tools and techniques for more effective reviews and assessments.
- Handle confidential information and documents with discretion and maintain their proper organization
- Conduct research and collaborate with other departments and team members to resolve any process discrepancies or issues
Clinical Services Operations Specialist
Noridian Healthcare Solutions
01.2023 - 06.2024
- Maintain a confidential-level security clearance while working on critical quality review projects for government claims
- Oversaw day-to-day operations, delegating tasks appropriately to ensure smooth workflow and timely completion of projects.
- Successfully managed multiple projects simultaneously while adhering to deadlines.
- Review and process medical and dental claims for accuracy and completeness using MCS and Cloud Dental
- Mentor new hires
- Handle confidential information and documents with discretion and maintain their proper organization
- Conduct research and collaborate with other departments and team members to resolve any claim discrepancies or issues
- Perform clerical tasks such as data entry, filing, and organizing claim documents
- Accurately prepare/process electronic records to and from workflows by routing to appropriate locations
Medical Records Clerk
Remx- Contractor for Ciox Health
01.2022 - 01.2023
- Conduct research and prepare reports on various topics related to the company's operations and industry trends
- Analyze and abstract medical documentation, including medical records and diagnostic reports
- Provide administrative support, including answering phone calls, responding to emails, and preparing correspondence
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Scanned medical records in digital format for easy retrieval and accessibility.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Ensured HIPAA compliance by adhering to strict confidentiality guidelines when handling sensitive patient information.
- Utilize ICD-9 and ICD-10 coding systems to accurately classify medical procedures and diagnosis
- Process medical record requests
- Maintain knowledge of current medical terminology
- Navigate EPIC and other various filing systems to retrieve all required elements of a medical chart
Care Facilitator
Jencare Medical Center
08.2018 - 04.2020
- Interact appropriately with patients while recording information during the check in and check out process
- Utilize multiple computer programs to input patient information, print out relevant forms for processing and schedule additional appointments
- Assist in the development, implementation, and evaluation of ongoing quality improvement processes
- Review, process and complete medical record requests using EPIC
- Handle confidential information and documents with discretion and maintain their proper organization
- Conduct research and collaborate with other departments and team members to resolve any referral discrepancies or issues
- Perform clerical tasks such as data entry, filing, and organizing medical documents
- Accurately prepare/process electronic records to and from workflows by routing to appropriate locations
Foreclosure Specialist
Fay Servicing
02.2017 - 08.2018
- Understand mortgage loans and other documents
- Utilize proprietary databases to create referral packages for consumers and manage the foreclosure process
- Create and maintain databases and spreadsheets
- Handle confidential information and documents with discretion and maintain their proper organization
- Conduct research and collaborate with other departments and team members to resolve any case discrepancies or issues
- Perform clerical tasks such as data entry, filing, and organizing case documents
- Ensure assigned foreclosure loans are handled in accordance with state laws and federal regulations
- Execute foreclosure loan boarding functions- Scripting, Data Validation, SCRA searched, Payoffs, Reinstatements...etc
Enforcement Program Assistant
Federal Motor Carrier Safety Administration
03.2013 - 10.2016
- Maintain a confidential-level security clearance while working on critical projects for government cases
- Coordinate and schedule meetings with team members for department updates
- Assist in the development, implementation, and evaluation of ongoing quality improvement processes
- Create, review and process denial/approval letters
- Handle confidential information and documents with discretion and maintain their proper organization
- Conduct research and collaborate with other departments and team members to resolve any case discrepancies or issues
- Perform clerical tasks such as data entry, filing, and organizing case documents
- Proficient in establishing, maintaining and updating tracking documents and records
- Experience collecting information for monthly reports
Education
Associates of Science (A.S.) -
Prairie State College
05-2025
High School Diploma -
Rich Central High School
01.2006
Skills
- Strong organizational skills
- Time management skills
- Exceptional communication skills
- Interpersonal skills
- Business Objects
- Ability to work independently
- Problem-solving abilities
- Detail-oriented
- Ability to handle multiple tasks simultaneously
- Experience in handling confidential documents
- Microsoft office
- Verbal communication
- Teamwork and collaboration
- Critical thinking
Securityclearances
Confidential-level clearance, 10/2023, Present
Timeline
Quality Review Analyst
Noridian Heathcare Solutions
06.2024 - Current
Clinical Services Operations Specialist
Noridian Healthcare Solutions
01.2023 - 06.2024
Medical Records Clerk
Remx- Contractor for Ciox Health
01.2022 - 01.2023
Care Facilitator
Jencare Medical Center
08.2018 - 04.2020
Foreclosure Specialist
Fay Servicing
02.2017 - 08.2018
Enforcement Program Assistant
Federal Motor Carrier Safety Administration
03.2013 - 10.2016
High School Diploma -
Rich Central High School
Associates of Science (A.S.) -
Prairie State College
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