Excel
Keely Garcia
New Braunfels
Summary
Results-driven Quality Analyst with Aetna, a CVS Health, expertise in quality improvement and data analysis. Proven track record in identifying process inefficiencies and implementing actionable solutions, fostering a culture of quality. Strong collaborator with exceptional problem-solving skills, dedicated to enhancing operational efficiency and customer satisfaction.
Overview
8
8
years of professional experience
Work History
Quality Analyst
Aetna, a CVS Health
06.2023 - Current
- Engaged in continuous learning of quality assurance methodologies and best practices.
- Identified process inefficiencies and recommended actionable improvements for increased productivity.
- Maintained up-to-date knowledge of quality assurance methodologies, applying best practices to daily tasks.
- Fostered culture of quality, encouraging proactive identification and resolution of potential quality issues.
Claims Processor
Aetna, a CVS Health
08.2019 - 06.2023
- Processed and reviewed insurance claims for accuracy and compliance with company policies.
- Collaborated with adjusters to gather necessary documentation for claim resolution.
- Utilized claims management software to track and update status of pending claims efficiently.
- Provided exceptional customer service by addressing inquiries and resolving issues promptly.
Dental Claims Processor
UnitedHealth Group
01.2019 - 05.2019
- Processed dental claims efficiently, ensuring compliance with industry regulations and standards.
- Reviewed documentation for accuracy, identifying discrepancies to enhance claim resolution rates.
- Coordinated with dental providers and insurance companies to clarify claim details and expedite processing.
- Trained junior staff on claims processing procedures, promoting knowledge sharing and operational efficiency.
Dental Customer Service
UnitedHealth Group
08.2017 - 01.2019
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
Education
High School Diploma -
Central High School
Fresno, CASkills
- Audit processes
- Quality improvement
- Quality processes
- Data analysis
Software
Timeline
Quality Analyst
Aetna, a CVS Health
06.2023 - Current
Claims Processor
Aetna, a CVS Health
08.2019 - 06.2023
Dental Claims Processor
UnitedHealth Group
01.2019 - 05.2019
Dental Customer Service
UnitedHealth Group
08.2017 - 01.2019
High School Diploma -
Central High School