Resourceful Quality Analyst Lead known for high productivity and efficient task completion. Specialize in process improvement, data analysis, and quality control methodologies. Excel in problem-solving, communication, and team collaboration to enhance operational effectiveness. Hardworking Worker known for high productivity and efficient task completion. Possess specialized skills in time management, quality control, and safety compliance. Excel in teamwork, communication, and adaptability, ensuring smooth operation and project success.
Hi, I’m
Quanda Grant
Greenville,SC
Summary
Overview
19
years of professional experience
1
Certification
Work History
TalentBridge/CaremetGreenville, SC
Quality Control
12.2024 - Current
Job overview
- Use JCodes to verify member eligibility and coverage for the insurance plan.
- Make sure the member's visit is either in-network or out-of-network.
- If they have a copay, coinsurance, deductible, or out-of-pocket expenses.
- Documenting/Recording Information — Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form.
- Evaluating information to determine compliance with standards — using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.
- Monitoring Processes, Materials, or Surroundings — Monitoring and reviewing information from materials, events, or the environment to detect or assess problems.
- Analyzing data or information—identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts.
- Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources.
- Analyzed process samples for quality control purposes.
- Inspected finished works for quality control purposes.
- Developed and maintained data quality control processes.
- Inspected printed material for quality control purposes.
Mastech Digital/ DeloitteGreenville, SC
Quality Assurance Analyst
09.2024 - 01.2025
Job overview
- Quality Analysts lead, Supervisor, SME
- Stop production if serious product is not workable task
- Review and update standard operating procedures, or quality assurance manuals.
- Monitor the performance of quality control systems to ensure effectiveness and efficiency.
- Review the quality documentation necessary for regulatory submissions.
- Analyze quality control test results, and provide feedback and interpretation to production management or staff.
- Verify that materials and finished products meet established requirements.
- Oversee workers, including supervisors and workers engaged in tasks and activities.
- Instruct staff in quality control and analytical procedures.
- Direct the tracking of regularly reported quality control data.
- Participate in the development of product specifications.
- Identify quality problems, or areas for improvement, and recommend solutions.
- Collect and analyze production samples to evaluate quality.
- Produce reports regarding nonconformance of tasks or processes, daily production quality, root cause analyses, or quality trends.
- Communicate quality control information to all relevant organizational workers.
- Monitor the development of new products to help identify possible problems for mass production.
- Identify critical points in the manufacturing process, and specify sampling procedures to be used at these points.
- Create and implement inspection criteria or procedures.
- Document criteria for RSA.
- Review statistical studies, technological advances, or regulatory standards and trends to stay abreast of issues in the field of quality control.
- Instruct workers on quality guidelines and ways to eliminate deficiencies that have been sent out.
- For the SME, ensure the facts and details are correct so that the project deliverable will meet the needs of the clients, policies, and standards, with the best practices of delivery.
- For the supervisor assistant, ensuring that the employees are productive and efficient with their tasks that comply with the policies and standards.
- Training of a new analyst who hits the floor.
- Reporting to the senior management, and reporting any issues.
- Analyzed existing application functionality against customer requirements ensuring compliance.
- Streamlined processes, increasing efficiency and consistency to support quality initiatives.
- Monitored production environment performance metrics for anomalies that could indicate quality issues.
- Assisted other members of the QA team in identifying areas for improvement in processes and procedures.
- Maintained policy, procedures, work instructions, and projects for quality and continuous improvement agendas.
- Reported issues in a timely manner with accurate descriptions and steps to reproduce them.
- Developed process improvements to enhance overall data quality.
Mastech Digital/ DeloitteGreenville, SC
Surge Support Analyst
04.2024 - 09.2024
Job overview
- Determine the eligibility of persons applying to receive assistance from government programs and agency resources, such as Medicaid.
- Medicare, Food Stamps, TANF, WIC, and more.
- Review the task to see if the cases are workable.
- Work changes and renewals application for clients with Medicaid for the state of Georgia.
- Work Pathway Applications.
- Nursing home applications.
- Verify liquid resources, such as checking and savings accounts, vehicles, trust accounts, and more.
- Different expenses and deductions.
- Run different interfaces like DOL-WG, WN (Worker Number), FD, UB (Unemployment), NHNFD.
- Use a different system gateway to run the case, and make case notes for the state worker to look at the case.
TEKsystems/ North HighlandColumbia, Remote
Eligibility Specialist
09.2023 - 04.2024
Job overview
- Determine the eligibility of persons applying to receive assistance from government programs and agency resources, such as Medicaid and Medicare.
- Going over cases to determine if the clients are still qualified for Medicaid, from adults to children.
- Send documentation to the applicant to update any of their information, from personal to income-based.
- Work with systems: OnBase, Clemson, Workday, MMIS, and Curam.
- Also uses Teams and Cisco Jabber to place calls and conferences.
- Convert SSI cases from MEDS to a system called Curam.
- Assisted with SSI, Medicaid, and Medicare cases.
- Review and analyze Medicaid.
- Medicare cases.
- Different programs, like QMB and Low Specialty Income Home, for the State of South Carolina.
- Perform clerical work in medical settings.
- Process healthcare paperwork.
- Classify materials according to standard systems.
- Code, data, or other information.
- Collect medical information from patients, family members, or other medical professionals.
- Processed client applications in accordance with established guidelines.
- Entered client information and files into databases for further review and tracking.
- Provided guidance on how to apply for benefits and answered questions related to the process.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Maintained comprehensive knowledge of program regulations, policies, and procedures.
- Ensured compliance with all applicable laws and regulations governing benefit programs.
- Verified applicant's identity and other relevant documents such as birth certificates or Social Security cards.
- Granted, modified, denied, or terminated assistance based on key information and eligibility determination.
- Informed applicants of other agencies providing useful or related assistance.
- Assisted clients with completing forms required for processing applications.
- Monitored client accounts for any changes that could impact eligibility requirements.
- Researched case histories, court decisions, legal articles, statutes, codes, and other data pertinent to determination of eligibility.
- Analyzed financial information provided by applicants to verify income levels.
- Reviewed applications to verify client information and resolve discrepancies.
- Explained eligibility details and affordability options to patients with kindness and respect.
Prisma Health (formerly Greenville Memorial Hospital)Greenville, Onsite
Patient Access Specialist- ER
09.2022 - 01.2024
Job overview
- Coordinate communication between patients, family members, medical staff, administrative staff, or regulatory agencies.
- Interview patients or their representatives to identify problems related to care.
- Refer patients to appropriate health care services or resources.
- Maintain knowledge of community services and resources available to patients.
- Explain policies, procedures, or services to patients using medical or administrative knowledge.
- Investigate and direct patient inquiries or complaints to appropriate medical staff members, and follow up to ensure satisfactory resolution.
- Read current literature, talk with colleagues, continue education, or participate in professional organizations, or conferences to keep abreast of developments in the field.
- Develop and distribute newsletters, brochures, or other printed materials to share information with patients, or medical staff.
- Provide consultation or training to volunteers or staff on topics such as guest relations, patients' rights, or medical issues.
- Analyze patients' abilities to pay, to determine charges on a sliding scale.
- Identify and share research, recommendations, or other information regarding legal liabilities, risk management, or quality of care.
- Collect and report data on topics such as patient encounters or inter-institutional problems, making recommendations for change when appropriate.
- Teach patients to use home health care equipment.
- Medical software — Epic EMR Systems, HCPCS, US Bank, One Source, InstaMed.
- Collect payment, void payment, collect bad debt payments.
- Train the new hire on the process of Patient Access in the Emergency Room.
- Data entry.
- Accounts Receivable
- Medical records, EMR.
- Schedules appointments appropriately and follows scheduling instructions in the EMR.
- Maintains current patient information, and confirms and updates demographics.
- Provide patients with the necessary paperwork and HIPAA information to maintain compliance.
- Maintains adequate front office supplies, and ensures supply purchases are cost-effective and within budget.
- Enters necessary IT and maintenance orders accurately and in a timely fashion.
- Responsible for gathering daily deposits from all necessary departments.
- Assists in new hire onboarding and training, and assists co-workers during downtime.
- Ensures adequate coverage for the reception area when team members are out.
- Works closely with the Office Coordinator/Director to identify and recommend solutions for front office issues and problems; attends 75% of all staff and departmental meetings.
- Oversees check-in/out and is able to answer questions regarding scheduling, co-pays, Phreesia, insurance, and health spaces as needed.
- Maintains an open line of communication with all staff members; interacts with staff and patients in a professional and constructive manner regarding directions, scheduling, messages, workflow changes, and necessary corrections.
- Maintains work areas and personal appearance in a way that reflects professionalism, orderliness, cleanliness, and safety.
- Perform clerical work in medical settings
- Process healthcare paperwork
- Classify materials according to standard systems
- Code, data, or other information.
- Collect medical information from patients, family members, or other medical professionals
- Review medical codes with doctors and nurses.
- Reviewed documentation for completeness and accuracy prior to submitting claims to payers.
- Verified patient insurance coverage, collected copays and other payments, processed credit card transactions.
- Drafted educational brochures and informative newsletters for patients and staff.
- Cultivated positive relationships with patients to help facility meet satisfaction scores and patients obtain best possible care.
- Organized and maintained records by updating and obtaining both personal and financial information from patients.
- Communicated financial obligations to patients and collected fees at time of service.
- Addressed patient inquiries and concerns, resolving issues in a timely and empathetic manner.
- Prepared daily reports on registration activities, highlighting areas for improvement.
- Managed patient check-in process, ensuring accurate data entry of personal and insurance information.
- Received patient inquiries or complaints and directed to appropriate medical staff members.
- Received and stored patients' valuables and other belongings, as requested.
- Performed data entry tasks associated with registrations such as entering demographic data into system database.
- Obtained health, financial and religious information from patients at time of admission.
- Applied HIPAA privacy and security regulations while handling patient information.
- Compiled information from patients and caregivers or family members to identify care concerns.
- Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
Blue Cross Blue ShieldGreenville, Hybrid/Remote
Claims Processor II
05.2021 - 01.2023
Job overview
- Uploaded documents relevant to claims.
- Transmit claims for payment, or further investigation.
- Prepare insurance claim forms, or related documents, and review them for completeness.
- Calculate the amount of the claim.
- Work on Medicare claims.
- Work preauthorization or pre-certification claims.
- Reach claims to make sure we pay them, or if they are covered, or the procedure is covered.
- Review CPT, HCPCS, ICD-9, and ICD-10 diagnosis codes.
- Corrected errors in submitted insurance claims.
- Compile, process, and maintain medical records of hospital and clinic patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the healthcare system.
- Standardized the coding system for healthcare-related information by categorizing diagnosis, services, and equipment.
- Assign the patient to diagnosis-related groups (DRGs), using appropriate computer software.
- Organized information in medical records to support various initiatives like research and quality enhancement.
- Consult classification manuals to locate information about disease processes.
- Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment, into the computer.
- Identify, compile, abstract, and code patient data, using standard classification systems.
- Perform clerical work in medical settings
- Process healthcare paperwork
- Classify materials according to standard systems
- Code, data, or other information.
- Collect medical information from patients, family members, or other medical professionals
- Electronic medical record (EMR) software, Healthcare Common Procedure Coding System (HCPCS) for Durable Medical Equipment, medical condition coding software, and medical procedure coding software.
- Analyzing patient records, and recording all the relevant information.
- Examining records and documentation for missing information.
- Assigning industry-recognized codes, such as ICD-10 and OPCS-4.
- Collaborating with physicians and other healthcare professionals to ensure information accuracy.
- Training other healthcare professionals on clinical coding practices.
- Ensuring that the healthcare facility complies with clinical coding guidelines.
- Carrying out our periodic audits of patients' medical charts.
- Ensuring that all clinical codes are current.
- Assigning and sequencing all codes for services rendered.
- Conducted and documented comprehensive investigations to negotiate settlements or deny claims.
- Reviewed history records to determine benefit eligibility for services.
- Performed additional duties as requested by management team.
- Processed a high volume of incoming claims in accordance with established policies and procedures.
CORESTAFF Services/ Maximus, Remote
Adjudicator
03.2020 - 04.2022
Job overview
- Team Lead.
- Assist with the PUA claim for the state of AZ, assist with 21 days, making sure the quarterly amounts equal up, and assist with customer support about claims.
- Use different types of systems, such as AWS, guided, on base, portals, and Microsoft systems.
- Recently promoted to the Emergency Rental Assistance Program (ERAP) for the state of AZ.
- Adjudicating applicants' applications so that they can get assistance for rental and their utilities.
- Make outbound calls to applicants to verify information.
- Sometimes, there is queue time (inbound calls) when help is needed with customer support.
- Assist my team members with questions.
- Uses Microsoft Office products, Word, Excel, Outlook, OneNote, Teams, and more.
- Also uses the AWS system and AZ DES system, OnBase.
Conduent, Remote
Technology Support Rep
03.2017 - 02.2019
Job overview
- Work from Home/ data entry
- Assist customers with their Apple products
- Including cells phone, apple watches, Bluetooth, Mac computers
- Troubleshooting of devices
- Setting up claims, orders, and store appointments
- Handle Angry customers at a cursory matter
- Work customer though on how to download software and update new software to their devices
- Assist with apple iTunes and apple music apps
- Assist customer with downloading iTunes, software, and third – party apps to their devices, mac computers and personal computers
- Help customer with apps by troubleshooting
- Teach customer how to transfer files from the devices to their cps and mac computer
- Teach customers how to make files on device, iPad, cps, and mac computers
- Teach and assist customer with spreadsheets on the computers, and cps
Wells FargoColumbia, SC
Customer Service Representative 2
11.2016 - 03.2017
Job overview
- Answer internal calls to assist the banker with accounts, holds, closing accounts, procedures, and dormant accounts
- Assist with claims for accounts and debit cards
- Work multiple computer systems at once as well as Microsoft Office different documents including word, outlook, power point, and excel
Sykes Enterprise IncSumter, SC
Customer Service Representative
12.2013 - 02.2016
Job overview
- Inbound call center, assist customers with their personal accounts with the bank
- Accounts were checking, savings, credit cards, new accounts, online banking, lost or stolen debit and credit cards, sales, customer services, fraud
TeleperformanceWest Columbia, SC
Customer Service Representative
10.2014 - 01.2015
Job overview
- Work for Well Care answer inbound calls check patient insurance information data entry update patient information the patient with account information billing assist patient with doctors and hospitals phone finding a doctor in a location
- Assist with insurance sales
- Was a team leader of 5 associates by assisting them with customers
InMed Diagnostic ServicesColumbia, SC
Coder
10.2012 - 12.2012
Job overview
- Greeting patient file medical charts make medical charts set up patient appointment scan patient information into the system make CDs
- Cancel appointment insurance billing
- Answer telephones and direct calls to appropriate staff
InMed Diagnostic ServicesColumbia, SC
Patient Service Representative/ Unit Secretary
10.2012 - 12.2012
Job overview
- Was working there for my internship while attending Virginia College for my degree in Medical Billing and Coding
- Work at the front desk to assist patients in the office and on the phone work multiple computer systems and check on the customer insurance
- Also, assist in the X-ray and the MRI department by answering calls and assisting the technician during procedures
- Obtains insurance information from patients and counsels’ alternative ways for financial assistance
- Communicates with physicians and clinical staff to assist with scheduling urgent or referred patient scheduling calls/requests
- Provides patient scheduling services to include collecting demographics and insurance registration
- Reviews schedule for new patients, updating when necessary
- Calls patients with appointment time reminder, obtaining insurance information and referral forms
- Process internal physician referral for clinical care
- Explains billing process to patients, answers incoming inquiries from patients and third-party payers
- Works with others to solve moderately complex problems
- Explains billing process to other staff; assists with basic account maintenance activities
- Assists patients with insurance questions regarding the billing process
- Assists staff with sending out reminder cards and other scheduling duties
- Works Relations patient reminder system results and contacts patients or makes scheduling changes
- Based on physician input may make daily edits and temporary changes to provider scheduling templates
- EPIC and Scheduling background
- Demonstrated interpersonal skills and working knowledge of insurance and financial options
- Effective customer service skills
- Prioritization and organizational skills
- Demonstrated ability with Microsoft office including Excel and Word
Steve and Barry'sSumter, SC
Sales Associate
07.2006 - 05.2008
Job overview
- Greet a customer restock the sales floor cashier assist customers with product assist teammate with product make sure the sales floor is in the order faction
- Assist with sales and was a manager
Education
Virginia College
Associates in Apply Science
University Overview
Virginia College
Certificate in Medical Billing and Coding
University Overview
Crestwood High SchoolSumter, SC
High school diploma or GED
University Overview
Skills
- HEDIS
- Customer Interaction
- Telecommunications Representative
- Desktop Troubleshooting Expertise
- Financial Services Expertise
- Troubleshooting Proficiency
- Healthcare Coding Expertise
- Application Performance Analysis
- Medical billing
- CPT coding
- Help Desk
- Network Support
- ICD-9
- Computer Networking
- Customer support
- Mobile devices
- HubSpot
- Insurance Policy Consultations
- VoIP
- Typing
- Windows
- IT support
- Mac OS
- Research
- Live chat
- Classroom experience
- HIPAA
- Google Docs
- Contracts
- Medical terminology
- Patient monitoring
- VPN
- SharePoint
- Transcription
- Medicare
- Care plans
- Documentation review
- Medical documentation
- Clinical research
- ICD-10
- HCPCS
- Accounts receivable
- Medical records
- Microsoft Access
- Analysis skills
- Teamwork
- Problem-solving
- Flexibility
- Microsoft Excel
- EMR systems
- Active Directory
- Reliability
- Data entry
- Medical office experience
- Research (7 years)
- Recruiting
- Science (3 years)
- Clerical experience
- Epic
- Confluence
- Data collection
- Adobe Acrobat
- Microsoft Office
- Insurance Verification
- Organizational Skills
- Leadership
- Microsoft Word
- Administrative Experience
- Communication Skills
- Sales
- Editing
- Filing
- Remote Access Software
- Operating systems
- Multi-line phone systems
- Risk management
- 4G/LTE
- Continuous improvement
- Human resources
- Computer skills
- Microsoft Windows Server
- Analytics
- Time management
- Citrix
- Medical receptionist
- Dental receptionist
Awards
Awards
- President list, 09/01/12, For a high GPA of a 4.0
- Leadership, 07/01/15, Was awarded this from Sykes from showing leadership and helping my peers.
- Dean list, 06/01/13, For having a GPA of a 3.5
Certification
- Medical Coding Certification
- Professional In Human Resources
Personal Information
Personal Information
Work Permit: Authorized to work in the US for any employer.
Assessments
Assessments
- Customer focus & orientation, Proficient, 01/01/22, https://share.indeedassessments.com/attempts/66e815bb476d4937c4e43736e4af27aceed53dc074545cb7
- Work style: Reliability, Proficient, 03/01/22, https://share.indeedassessments.com/attempts/f1f431853c4b2b388c08ad4c839d1551eed53dc074545cb7
- Call center customer service, Proficient, 09/01/21, https://share.indeedassessments.com/attempts/13c7c55be4a9ed8aa231b8e4cdc6a8c7eed53dc074545cb7
Timeline
Quality Control
TalentBridge/Caremet
12.2024 - Current
Quality Assurance Analyst
Mastech Digital/ Deloitte
09.2024 - 01.2025
Surge Support Analyst
Mastech Digital/ Deloitte
04.2024 - 09.2024
Eligibility Specialist
TEKsystems/ North Highland
09.2023 - 04.2024
Patient Access Specialist- ER
Prisma Health (formerly Greenville Memorial Hospital)
09.2022 - 01.2024
Claims Processor II
Blue Cross Blue Shield
05.2021 - 01.2023
Adjudicator
CORESTAFF Services/ Maximus
03.2020 - 04.2022
Technology Support Rep
Conduent
03.2017 - 02.2019
Customer Service Representative 2
Wells Fargo
11.2016 - 03.2017
Customer Service Representative
Teleperformance
10.2014 - 01.2015
Customer Service Representative
Sykes Enterprise Inc
12.2013 - 02.2016
Coder
InMed Diagnostic Services
10.2012 - 12.2012
Patient Service Representative/ Unit Secretary
InMed Diagnostic Services
10.2012 - 12.2012
Sales Associate
Steve and Barry's
07.2006 - 05.2008
Virginia College
Associates in Apply Science
Virginia College
Certificate in Medical Billing and Coding
Crestwood High School
High school diploma or GED
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