Result driven Quality Assurance Analyst with expertise in health insurance, claims processing and customer service. Bilingual in English and Spanish with strong skills in payroll. Proven ability to deliver exceptional support to clients and team.
Overview
13
13
years of professional experience
1
1
Certification
Work History
QA Analyst & Reviewer
Vijilent
10.2021 - Current
Record findings of inspection process, collaborating with quality team to implement corrective actions.
Provide regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
Deliver research services to attorneys for jury trials, ensuring accurate and reliable case preparation.
Create social media analysis reports on case individuals, enhancing investigative efficiency and evidence gathering.
Enrollment Specialist
Accenture
11.2024 - 05.2025
Communicated effectively with prospective customers.
Accurately updated, entered, and reviewed customer data.
Conducted thorough research on available health insurance plans and policy changes.
Enhanced customer satisfaction by providing accurate and timely information on health and dental insurance policies and benefits.
Health Insurance Representative
Everise
01.2024 - 10.2024
Verified coverage and processed policy updates for 50+ customers daily, ensuring accurate and timely service.
Answered 40+ daily inbound calls from policyholders and providers, resolving coverage inquiries and improving first call resolution rates while maintaining compliance with HIPPA regulations
Researched and resolved complex medical claims issues to support timely processing.
Front Desk Receptionist
Americas Best Contacts And Eyeclasses
05.2017 - 05.2018
Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
Checked patient data including insurance, demographic and health history to keep information current.
Collected fees and payments.
Scheduled, coordinated and confirmed appointments.
Payroll Assistant
W&W Delivery LLC
08.2013 - 03.2014
Verified timekeeping records and handled any discrepancies with employees.
Maintained payroll information by calculating, collecting, and entering data.
Protected sensitive payroll information and built employee trust by maintaining confidentiality
Bilingual Customer Service Representative
Computer Generated Solutions Inc.
07.2012 - 07.2013
Gained customer trust by providing knowledgeable and accurate information in both English and Spanish.
Answered up to 120 incoming calls in busy, fast-paced call center.
Adhered to company policies and scripts to consistently achieve call-time and quality standards.
Responded to customer requests for products, services and company information.
Billing and Coding Associate at Quick Claimers Medical Billing and CredentialingBilling and Coding Associate at Quick Claimers Medical Billing and Credentialing