
Dedicated Customer Service Representative with extensive experience in
high-volume call centers, remote work, and on-site environments. Skilled in billing
support, technical troubleshooting, claims handling, and delivering excellent
customer experiences. Known for professionalism, adaptability, and achieving
high satisfaction ratings. Results-driven professional with expertise in conducting thorough audits and data extraction. Proven track record of enhancing reporting accuracy and compliance in HEDIS quality standards.
Conducted thorough audits of medical records to ensure compliance with HEDIS quality reporting
standards, resulting in enhanced reporting accuracy • Extracted HEDIS records from databases, reviewed medical documentation per HEDIS technical
specifications, and annotated results in Adobe PDF • Evaluated medical records against clinical criteria to confirm consistency with HEDIS and CMS
performance measures, contributing to improved quality assurance • Improved data collection processes, increasing efficiency and accuracy in HEDIS-related
overreading activities.