Kristin Addison
Callahan,FL
Summary
Versatile and results-oriented professional with extensive experience in quality assurance and compliance, notably at BCBSFL/Guidewell. Excelled in audit management and team building, achieving audit scores averaging 90% or above. Skilled in data analytics and critical thinking, adept at enhancing compliance standards and operational efficiency. Logical Compliance Auditor self-sufficient and determined with a professional attitude and demeanor. Skilled at ensuring regulation guidelines are being followed and regulations are being met. Analytical finance professional known for high productivity and efficient task completion. Specialize in financial reporting, tax planning, and compliance auditing. Excel in problem-solving, critical thinking, and effective communication. Committed to maintaining accuracy and integrity in all accounting processes.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Quality assurance and compliance auditor QA lead
BCBSFL/Guidewell
, USA
01.2020 - Current
- Company Overview: Quality assurance and compliance auditor QA lead
- Florida Blue/Guidewell responsible for generating and implementing quality standards, conducting audits while monitoring and ensuring compliance standards in production
- Responsible for generating and implementing quality standards, conducting audits while monitoring and ensuring compliance standards in production
- Inspecting processes and outputs and checks the implementation of the quality management system and conducts quality assurance compliance audits
- Identify the root cause of quality problems, document them and correct them if deficits are uncovered
- Maintain and develop internal support and call center quality assurance standards
- Track, analyze, and Report trends especially non-compliance issues
- Training agents, testing agents for cross functional systems
- Investigative process development for improving compliance
- Improve processes for business operations
- Analyze data to metrics to track trends
- Analyze track and Report all HIPPA FTC FCC compliance violations
- Quality assurance and compliance auditor QA lead
- Florida Blue/Guidewell responsible for generating and implementing quality standards, conducting audits while monitoring and ensuring compliance standards in production
Agent-Broker (Hybrid telesales agent)
Guidewell
Jacksonville, USA
01.2019 - Current
- Company Overview: Guidewell Connect Agent / Broker Hybrid (both Medicare and Under 65) 1+ years' experience as Telesales agent (inbound/ outbound)
- Excellent verbal and written communication skills
- Proven history with high quality and compliance scores and exceptional attention to policy and procedures according to Corporate, State, and Federal guidelines
- Consistent and proven record of high production with audit scores averaging 90% or above
- Experience with Citrix, Salesforce, Five-9, State of Heath Marketplace, Verint, and Booking Bug
- Guidewell Connect Agent / Broker Hybrid (both Medicare and Under 65) 1+ years' experience as Telesales agent (inbound/ outbound)
Teacher
Kelly Educational Services
Jacksonville, USA
01.2015 - 01.2019
- Teaching core curriculum K-12
Investigator OPS
4th District Public Defenders Office of Matt Shirk
Jacksonville, USA
01.2015 - 01.2017
- Investigator OPS/ Intern
- Specializing in mental health evaluations, investigations and interviewing of witnesses, clients, evidence tracking and video surveillance for evidence in assisting defense
- Evidence collections such as pictures of injuries
- Literacy evaluations and psychological questioning with personal information gathering to prepare defense for clients
- Interview and assessment for Psychological evaluations and mitigation
Tutor
Achieve Success Tutoring
Jacksonville, USA
01.2011 - 01.2013
- Company Overview: Duval Co School System Tutor
- Provide in home or school training
- Developed and implement new learning plans for student
- Evaluate weaknesses and assist in understanding the weaknesses he or she demonstrates
- Help and assist students understand and learn various academic subjects
- Duval Co School System Tutor
Operations Director/COO
B.E Construction Inc.
Atlanta, USA
01.2003 - 01.2009
- Provided direction for on-site training
- Developed new process for employee evaluation which resulted in marked performance improvements
- Monitored multiple databases to keep track of all company inventories
- Effectively controlled the release of proprietary and confidential information for general client lists
- Completed all company insurance renewals including property, workers' compensation, and general liability documents
- Chief Operating Officer with daily operational functions
- Analyzed departmental documents for appropriate distribution and filing
- Obtained documents, clearances, certificates, and approvals from local, state, and federal agencies
- Maintained all OSHA compliance records
CRC1
Gateway Larc. Georgia Mountain Community SVS.
Dahlonega, USA
01.1999 - 01.2002
- Effectively controlled the release of proprietary and confidential information for general client needs
- Collect data and find resources to help client develop strategy for all life needs
- Help client with medical, health, educational, employment, housing, and physical needs
- Support for Psychological, financial, and physical needs assistance
- Family support and education on client's needs
- Procuring financial support and resources for needs
- ISP and IEP planning, charting and implementing
- Goal setting for client with support
Lab Tech Asst. / Phlebotomist
Chestatee Regional Hospital
Dahlonega, USA
L.P.N.
Hidden Lake Academy
- Company Overview: Psychiatric Private School
- Psychiatric Private School
C.N.A
Georgia Baptist Buford Manor
- Company Overview: Long Term Care
- Long Term Care
C.N.A
Lakeshore Heights Nursing Care Facility
Brawner Psychiatric Hospital
- Company Overview: Med
- Sec
- Outpatient Care
- Med
- Sec
- Outpatient Care
North Fulton Hospital
- Company Overview: Med/Surg
- Med/Surg
Massachusetts's Indemnity Life Insurance Co.
- Company Overview: Agent Lic
- And Reinstatements
- Agent Lic
- And Reinstatements
Education
M.S.F.P. - Forensic Psychology
Walden University
01.2017
Adult Forensic Examiner Cert. - Forensic Psychological Assessments, Evaluations, and Examinations
University of South Florida
01.2016
B.S.P. - Psychology
University of Phoenix
01.2015
Piedmont College
Demorest, GA01.1999
A.S. L.P.N. - Licensed Practical Nursing
Gwinnett Tech University
Lawrenceville, Georgia01.1998
Skills
- Microsoft Office Suite
- Word
- Excel
- Access
- PowerPoint
- Outlook
- Citrix
- Salesforce
- Five9
- State of Health Marketplace
- Verint
- Booking Bug
- Customer Connect
- HEDIS
- Data analytics
- Software knowledge
- Auditing experience
- Critical thinking
- Audit management
- Team building
- Non-compliance assessment
- Microsoft office
- Financial reporting
- Data interpretation
- Staff training
- Strong computer skills
Additionalworkexperience
- Lab Tech Asst. / Phlebotomist, Chestatee Regional Hospital, Dahlonega, GA
- L.P.N., Hidden Lake Academy Psychiatric Private School
- C.N.A, Georgia Baptist Buford Manor Long Term Care
- C.N.A, Lakeshore Heights Nursing Care Facility
- Med. Sec. Outpatient Care, Brawner Psychiatric Hospital
- Med/Surg., North Fulton Hospital
- Agent Lic. and Reinstatements, Massachusetts's Indemnity Life Insurance Co.
Certification
- 240 Health license
Timeline
Quality assurance and compliance auditor QA lead
BCBSFL/Guidewell
01.2020 - Current
Agent-Broker (Hybrid telesales agent)
Guidewell
01.2019 - Current
Teacher
Kelly Educational Services
01.2015 - 01.2019
Investigator OPS
4th District Public Defenders Office of Matt Shirk
01.2015 - 01.2017
Tutor
Achieve Success Tutoring
01.2011 - 01.2013
Operations Director/COO
B.E Construction Inc.
01.2003 - 01.2009
CRC1
Gateway Larc. Georgia Mountain Community SVS.
01.1999 - 01.2002
Lab Tech Asst. / Phlebotomist
Chestatee Regional Hospital
L.P.N.
Hidden Lake Academy
C.N.A
Georgia Baptist Buford Manor
C.N.A
Lakeshore Heights Nursing Care Facility
Brawner Psychiatric Hospital
North Fulton Hospital
Massachusetts's Indemnity Life Insurance Co.
M.S.F.P. - Forensic Psychology
Walden University
Adult Forensic Examiner Cert. - Forensic Psychological Assessments, Evaluations, and Examinations
University of South Florida
B.S.P. - Psychology
University of Phoenix
Piedmont College
A.S. L.P.N. - Licensed Practical Nursing
Gwinnett Tech University
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