Jessica Shor
Palatine,IL
Summary
Determined Training & Quality Assurance Specialist with success in prioritization and multitasking while being dedicated to quality and accuracy. Experienced with handling multiple projects in a high volume environment. Exceptional and communication and organizational skills.
Overview
13
13
years of professional experience
Work History
Training & Quality Specialist
Medline Industries, LP
11.2021 - Current
- Record findings and collaborate with management and staff to implement corrective actions by evaluating approximately 50 agents monthly.
- Conduct new hire and refresher trainings for employees in each Revenue Cycle team.
- Create and maintain training materials for all Revenue Cycle functions.
- Maintain shared files and processes on SharePoint site.
- Create processes based on business and payer needs.
- Create and maintain team communications and updates (training updates, payer changes, process/procedure updates).
- Maintained confidentiality of medical records and sensitive information to comply with HIPAA regulations.
- Process Authorization to Release Medical Records requests.
- Provide coaching opportunities based on employee performance.
- Perform audits and provide performance feedback, training, and assess errors from monitored orders and/or claims.
- Educate employees on specific QA standards and confirmed maintenance of standards.
- Analyze quality and performance data to support operational decision-making.
- Provide regular updates to team leadership on quality metrics.
- Maintain knowledge and training materials for various roles such as documentation, verification, and prior authorizations.
- Promote adherence to quality standards by educating employees on SOP's.
- Implement process improvements to increase productivity in quality assurance operations.
- Identify issues to improve workflows.
- Collect and analyze data to measure effectiveness of quality control processes.
- Maintain knowledge of insurance coverage benefit levels, eligibility systems and verification processes.
Dedicated Service Representative
Medline Industries, LP
04.2018 - 11.2021
- .Managed supply needs for approximately 1,000 home health agencies
- Provided agencies and sales representatives with product information.
- Assisted with system inquiries.
- Presented contract procedures to ensure accuracy of information.
- Provided feedback to sales representatives regarding customer requests.
- Processed high volume of patient insurance orders.
- Identified, analyzed, and reported system issues.
- Provided agency's item usage data to sales analyst.
- Detailed insurance coverage to agencies and sales representatives.
- Processed operational service issues.
- Collaborated with team members to produce highly efficient solutions.
Homecare Account Manager
Medline Industries, LP
04.2017 - 04.2018
- Created and managed patient insurance accounts and medical supply orders.
- Organized, tracked, and presented order data to management.
- Utilized insurance formularies to ensure accuracy of medical billing.
- Applied understanding of ICD-10 and HCPCS codes to provide timely shipping, billing and receipt of supplies.
- Assisted with replacing, crediting, and tracking orders.
- Partnered with reimbursement regarding formulary rules and exceptions.
- Reviewed medical documentation that was submitted to insurance companies to ensure profitable revenue cycles.
- Mentored new hires to assist with escalations and system issues.
- Lead side by side training with new agents and provided coaching opportunities.
Business Development Center Supervisor
Affinitiv
12.2014 - 03.2017
- Supervised team of 50 employees.
- Processed automotive dealership sales and service contracts.
- Personalized invitations for dealership events.
- Assisted agents with escalated phone calls.
- Partnered with manager to conduct employee interviews.
- Created new training program.
- Implemented new quality assurance program.
- Provided employees with coaching opportunities
- Conducted employee performance reviews.
- Created strategies to improve employee performance.
- Maintained strong client base to retain client and customer relationship.
- Generated new business with marketing initiatives and strategic plans.
- Reached out to potential customers via telephone, email, and in-person inquiries.
- Established relationships with key decision-makers within customer's organization to promote growth and retention.
- Performed client research and identified opportunities for account growth.
- Established key performance indicators to track and analyze business progress and adjust strategies accordingly.
- Maintained up-to-date knowledge of products and services offered to customers.
- Improved productivity of customer service team by leading training initiatives.
- Communicated customer feedback and complaints to team members to promote proper resolution.
- Trained and coached team members on best practices for customer service and sales techniques.
- Provided leadership, guidance, and direction to team members.
- Developed and implemented strategies to increase sales and improve customer service.
Customer Service Representative
Affinitiv
06.2010 - 12.2014
- Managed approximately 60-90 customer calls per day.
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Provided side by side training to new hires
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Responded to customer calls and emails to answer questions about products and services.
- Evaluated customer information to explore issues, develop potential solutions, and maintain high-quality service.
Education
Bachelor of Arts - Sociology and Justice Studies
Northeastern Illinois University
Chicago, IL12.2014
Skills
- Quality Assurance
- Training
- Auditing
- Planning and Coordination
- Team Leadership
- Group and Individual Instruction
- Process Creation and Improvement
- Performance Tracking and Evaluation
- Proficient in Microsoft Office, SAP, OnBase, SharePoint, JIRA, Five9, Virtual Observer, Avaya Phone Software
Timeline
Training & Quality Specialist
Medline Industries, LP
11.2021 - Current
Dedicated Service Representative
Medline Industries, LP
04.2018 - 11.2021
Homecare Account Manager
Medline Industries, LP
04.2017 - 04.2018
Business Development Center Supervisor
Affinitiv
12.2014 - 03.2017
Customer Service Representative
Affinitiv
06.2010 - 12.2014
Bachelor of Arts - Sociology and Justice Studies
Northeastern Illinois University
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