Luzy-Ann Yanson
Summary
Detail oriented team player with strong organizational, multi-tasking and customer service skills. Highly effective and comfortable working with people at all levels in the organization. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
15
15
years of professional experience
Work History
Owner
Remy, LLC Dba Turbo Clean
2017.11 - Current
- Oversee daily operations, ensuring all jobs were completed accurately and efficiently by the technicians such as managing and dispatching the daily schedule of carpet cleaning and or floor cleaning jobs and ensuring the arrival times are met and that the jobs were met to the satisfaction for each residential customer and or commercial client which led to maintaining a 5 star review.
- Scheduled employees for shifts, taking into account customer traffic and employee strengths.
- Increased customer satisfaction by implementing efficient business processes and providing exceptional service.
- Developed and maintained strong relationships with clients, resulting in repeat business and referrals.
- Implemented marketing strategies to increase brand awareness and attract new customers.
- Negotiated contracts with suppliers for better pricing and terms, reducing overall costs for the business.
- Handled problematic customers and clients to assist lower-level employees and maintain excellent customer service.
- Hired trained, and managed a high-performing team of employees dedicated to achieving company goals.
- Monitored daily cash discrepancies, inventory shrinkage and drive-off.
- Processed invoices and followed up on outstanding balances.
- Analyzed client contracts to ensure accurate billing as per agreed terms, minimizing disputes and maintaining positive relationships.
Quality Management/Appeals Analyst
Anthem
2010.07 - 2017.12
- Improved the efficiency of the appeals process by reviewing and analyzing claim denials and discrepancies.
- Synthesized data into comprehensive quarterly written reports for management.
- Enhanced customer satisfaction with timely resolution of appeals, addressing concerns thoroughly and professionally.
- Streamlined workflows for faster decision-making, evaluating medical records and other documentation to support appeals decisions.
- Collaborated with interdisciplinary teams to ensure accurate claims adjudication, reducing errors and inconsistencies in the review process.
- Managed a high volume of cases, prioritizing tasks effectively and meeting strict deadlines for appeals resolutions.
- Maintained detailed records and organized documentation to facilitate smooth appeals processing, ensuring all relevant information was readily available for review.
- Communicated complex information clearly to the Medical Director and Appeals nurse, presenting findings and recommendations to guide decision-making processes.
- Navigated regulatory requirements proficiently, adhering to state and federal guidelines throughout the appeals process.
- Handled escalated cases adeptly, applying advanced problem-solving skills to resolve highly complex or contentious issues.
- Facilitated cross-departmental collaboration by working closely with clinical staff during case reviews.
Quality Management
APS Healthcare
2009.05 - 2010.06
- Scheduled and chaired quality review meetings to review effectiveness of performance mitigating risk, improving throughput and achieving customer satisfaction.
- Recorded, analyzed, and distributed statistical information.
- Collaborated with cross-functional teams to identify root causes of quality issues and develop corrective action plans.
- Participated in URAC and NCQA audits.
- Created policies and procedures for QM and the appeals process.
- Scheduled and prepared the QM reports, minutes for the QM quarterly meetings.
Education
Bachelor of Science - Health Administration
California State University -Northridge
Northridge, CA05.1998
Skills
- Health Administration
- Quality Management
- Utilization Management
- Credentialing
- HIPAA Compliance
- Microsoft Office Suite, Power Point
Timeline
Owner
Remy, LLC Dba Turbo Clean
2017.11 - Current
Quality Management/Appeals Analyst
Anthem
2010.07 - 2017.12
Quality Management
APS Healthcare
2009.05 - 2010.06
Bachelor of Science - Health Administration
California State University -Northridge
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