Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

KAILA DUARTE

PEORIA,AZ

Summary

Well-versed in virtual learning, virtual learning platforms, and comfortable in adopting new technology. Self-motivated and talented professional who aims for a challenging position. Sound exposure and excellent understanding of executing quality assurance audits, creating process improvements, and utilizing feedback for research methodologies to amplify work productivity. Competent in efficiently performing and serving within healthcare environments and providing assistance in various technology platforms, managing large groups, and implementing set policies. Capable of working under pressure and meeting performance targets. Self-starter who takes initiative, displays leadership, and communicates effectively with people at all levels. Proficient in MS Office Suite and hospital EMR systems.

Overview

9
9
years of professional experience
1
1
Certification

Work History

Health Plan Performance Analyst

Banner Healthcare
08.2023 - Current
  • Proactively identified potential risks within projects via thorough risk assessment activities, mitigating negative impacts on project outcomes.
  • Streamlined reporting processes for increased efficiency and improved decision-making capabilities.
  • Conducted comprehensive gap analyses to identify areas of opportunity and drive continuous improvement efforts.
  • Supported executive decision-making with insightful dashboard development, highlighting critical business KPIs.
  • Collaborated with cross-functional teams to develop and implement performance improvement.
  • Drove customer satisfaction improvements through focused analysis on service delivery processes and customer feedback trends.
  • Informed strategic planning through the provision of timely, accurate, and actionable insights derived from performance data analyses.
  • Evaluated current processes to develop improvement plans.
  • Reviewed internal systems and organized training plans to address areas in need of improvement.

Training and Quality Assurance Manager

Delta Dental of Arizona
10.2022 - 08.2023
  • Assessed existing policies and procedures to meet goals and objectives and encourage on-time reviews.
  • Established governance, organization and management structure to meet program protocols.
  • Monitored operations metrics to deliver regular reporting to senior leadership.
  • Provided ongoing training for staff members on best practices in auditing, enhancing their skills and productivity levels.
  • Established a culture of continuous improvement within the team by encouraging feedback and promoting open communication.
  • Developed workflow applications to facilitate document review and revision processes.
  • Partnered with auditors to track errors and add contributions to maintain accuracy.

Health Plan Trainer, Quality Analyst

BANNER PLAN ADMINISTRATION - AZ
08.2015 - 10.2022
  • Provided one-on-one mentoring to help individuals reach their full potential within the organization.
  • Monitored and reported trainee progress, introducing new learning tools to address individual needs.
  • Analyzed team performance and identified opportunities for additional training.
  • Developed effective training plans based on department needs and objectives.
  • Enhanced trainee engagement through interactive workshops and hands-on activities.
  • Promoted a culture of continuous learning within the organization by advocating for ongoing professional development opportunities.
  • Performed continuous evaluations of content and plans to enhance delivery and improve effectiveness.
  • Increased employee satisfaction by introducing flexible learning options such as self-paced courses and remote workshops.
  • Created and revised procedures, checklists and job aids to reduce errors.
  • Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
  • Designed and delivered web-based, self-directed learning materials.

Medical Coder

Desert West Obstetrics & Gynecology
12.2015 - 09.2022
  • Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.
  • Reviewed patient charts to better understand health histories, diagnoses, and treatments.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Maintained a high level of productivity while consistently meeting deadlines for claim submissions.

Education

Master's degree - Education Learning And Technology; Adult Principles

WESTERN GOVERNORS' UNIVERSITY
01.2021

Bachelor of Arts - Interdisciplinary Studies; emphasis in Communication

NORTHERN ARIZONA UNIVERSITY
01.2018

Skills

  • Training Development
  • Quality Assurance
  • Performance Management
  • Excel expertise
  • Adaptive Learning
  • Predictive Analytics
  • Quantitative Analysis
  • Business Analysis
  • Risk Assessment
  • Client Relationship Management
  • Data Collection
  • Trend Analysis
  • Teamwork and Collaboration
  • Problem-Solving
  • Time Management
  • Flexible and Adaptable
  • Excellent Communication
  • Problem Resolution

Certification

  • PENN FOSTER, Certificate in Medical Billing and Coding; Certified Medical Coder AAPC License 01753070
  • EAST VALLEY INSTITUTE OF TECHNOLOGY, Certificate in Surgical Technology, Certified Surgical Technologist CST NBSTSA License 198292
  • Six Sigma Certified - Currently in Progress

Timeline

Health Plan Performance Analyst

Banner Healthcare
08.2023 - Current

Training and Quality Assurance Manager

Delta Dental of Arizona
10.2022 - 08.2023

Medical Coder

Desert West Obstetrics & Gynecology
12.2015 - 09.2022

Health Plan Trainer, Quality Analyst

BANNER PLAN ADMINISTRATION - AZ
08.2015 - 10.2022

Master's degree - Education Learning And Technology; Adult Principles

WESTERN GOVERNORS' UNIVERSITY

Bachelor of Arts - Interdisciplinary Studies; emphasis in Communication

NORTHERN ARIZONA UNIVERSITY
KAILA DUARTE