Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Penny Prince

Bloomer

Summary

Accomplished Senior Claims Quality Analyst at UnitedHealthcare with expertise in data analysis and quality improvement. Led teams to streamline operations, enhancing productivity. Skilled in training implementation and fostering teamwork, driving process improvements and customer satisfaction. Proficient in corrective action planning and procedural updates, ensuring high-quality standards and operational excellence.

Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.

Overview

12
12
years of professional experience

Work History

Senior Claims Quality Analyst

UnitedHealthcare
09.2016 - Current
  • Analyzed quality and performance data to support operational decision-making.
  • Created and revised procedures, checklists and job aids to reduce errors.
  • Developed and maintained quality assurance procedure documentation.
  • Provided detailed reports on quality metrics to senior management, enabling informed decision-making regarding process improvements.
  • Identified process inefficiencies through meticulous data analysis, leading to streamlined operations and increased productivity.
  • Conducted thorough root cause analyses on recurring defects, resulting in the implementation of effective corrective actions.
  • Led quality assurance teams in high-stakes projects, maintaining focus on deliverables under tight deadlines.

Benefit Configuration Quality Team Lead

UnitedHealthcare
07.2015 - 09.2016
  • Trained new team members by relaying information on company procedures and safety requirements.
  • Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
  • Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
  • Coached team members in techniques necessary to complete job tasks.
  • Promoted a culture of excellence within the organization, consistently emphasizing the importance of maintaining high-quality standards throughout all aspects of operations.
  • Revised and drafted policies and procedures to address deficiencies comprehensively.
  • Monitored staff organization and suggested improvements to daily functionality.
  • Scheduled and chaired quality review meetings to review effectiveness of performance mitigating risk, improving throughput and achieving customer satisfaction.
  • Reported production malfunctions to managers and production supervisors.

Senior Claims Quality Representative

UnitedHealthcare
07.2013 - 11.2013
  • Trained new hires on company quality policies, fostering a culture of continuous improvement.
  • Improved product quality by implementing strict inspection procedures and identifying areas for improvement.
  • Enhanced overall efficiency with thorough root cause analysis and implementing corrective actions.
  • Collaborated with cross-functional teams for timely resolution of quality issues, increasing customer satisfaction.
  • Educated employees on specific QA standards and confirmed maintenance of standards.
  • Followed standard operating procedures for inspections and tests.

Education

High School Diploma -

Colfax Public Schools
Colfax, WI

Skills

  • Audit processes
  • Quality improvement
  • Data analysis
  • Procedural updates
  • Training implementation
  • Correction action planning
  • Defect tracking
  • Collaborative team player
  • Teamwork and positive attitude
  • Decision-making

Accomplishments

  • Collaborated with team of 5 in the Remark Comment Improvement Project, Lead on the project for Medicare and Medicaid lines of business.
  • Team Lead on a team of 12 members for the Benefit Configuration Team.
  • Team Lead for a team of 24 members in India for the Provider Reconsideration/Adjustment Team.
  • Led a Coordination of Benefits project, which led to numerous process improvements in that area.


Timeline

Senior Claims Quality Analyst

UnitedHealthcare
09.2016 - Current

Benefit Configuration Quality Team Lead

UnitedHealthcare
07.2015 - 09.2016

Senior Claims Quality Representative

UnitedHealthcare
07.2013 - 11.2013

High School Diploma -

Colfax Public Schools

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