Renee L. Hardemon
Columbia,SC
Summary
Quality assurance professional with a proven track record in developing innovative solutions that align with evolving customer and business needs. Expertise in optimizing operational efficiency and effectiveness. Strong analytical skills and attention to detail drive consistent quality improvements.
Overview
18
18
years of professional experience
Work History
Provider Enrollment Analyst
BlueCross Blue Shield of South Carolina
11.2024 - Current
- Provide in-depth review and verification/validation of provider data.
- Process/enter/update provider data information/applications into appropriate enrollment database used in evaluating/tracking the processing of the application and/or updating of provider directories.
- Provide quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone).
- Obtain information from internal department, providers, government and/or private agencies, etc. to resolve discrepancies/problems.
- Supply enrollment applications and general information on the enrollment process to interested enrollees.
- Contribute to and participates in special projects related to provider files. Assist technical support staff with testing system changes related to provider files.
- Assist with process improvements related to provider enrollment.
- Assist with provider education and provider services training.
Quality Assurance Analyst
Teleperformance
01.2021 - 09.2023
- Experience with managing time, having entrepreneurial spirit and strong passion for consumer products success.
- Accurately perform observations on recorded or live agent calls and score them against a TP and client provided standard.
- Determine whether agents are using proper procedures and efficient and effective practices to provide excellent customer service and support.
- Insurance claims and legal experience.
- Wide range of experience answering telephones, maintaining logs/records, organizational skills, proficiency with numbers, research information, time management, training employees, using computerized databases, written and verbal communications.
- Ability to drive results, compile data-driven results and clearly communicate to departments.
- Ability to manage multiple projects simultaneously.
- Maintain project timeframes, objectives, and communications for assigned projects.
- Strong knowledge and experience with MS office applications including Outlook, Word, Excel, and PowerPoint.
- Excellent interpersonal, written and spoken communication skills, and organizational skills
Permit Services Specialist
City of Hollywood
10.2016 - 12.2020
- Receive and review permit applications and supporting documents for proper form, sufficiency of information, and conformance with department policies and legal standards to ensure permits are processes in accordance with requirements.
- Assess new applications and compare scope of project with existing permits for relevancy.
- Greet and assist customers, provided information, and answer questions for the public regarding departmental policies and procedures pertaining to permits.
- Answer phones and provide information as requested, route calls as necessary.
- Collect fees and prepare daily reports.
- Issue permits after they have been reviewed and approved.
- Register and update contractors to ensure license requirements have been satisfied
- Perform data entry and file maintenance as required by position, scan and archive documents as required.
Front Office Specialist/Physical Therapy Tech
Concentra Urgent Care
05.2012 - 11.2016
- Greets patients and visitors and directs them accordingly.
- Handles medical records.
- Verify health insurance per protocol.
- Obtains authorization as needed to process patients for services needed.
- Patients into OccuSource or manually in accordance with client company protocols.
- Explains all required paperwork and forms to patients and ensures proper completion of all paperwork.
- Answers incoming telephone lines in accordance with company procedures and directs the caller accordingly.
- Checks out patients either via Occusource or manually according to procedure and distributes records according to the Employer's protocols.
- Files paperwork, medical records and correspondence according to defined company procedure.
- Dissemination of all paperwork to outside parties including non-injury paperwork, custody and control forms.
- Assists in processing patient referrals as required.
- Follows HIPAA guidelines and safety rules as outlined in training received
Quality Assurance Support/ Human Resources Assistant
St. Albans Child Enrichment Center
10.2007 - 05.2012
- Assist in writing and submitting reports and forms required by Funders
- Type correspondence, memos, surveys, and other materials; arrange format and content for effective presentation of information; revise and draft forms as needed.
- Establish and maintain computer records, including recruitment files and tests, general files and other information on sick leave, payroll, vacation pay, attendance cards, and hourly time records; maintain confidential employee information and records.
- Perform office services such as filing of documents, duplication, stocking of supplies and monitoring of equipment.
- Maintain an accurate employee telephone list and other necessary databases.
- Answer incoming calls and transfers to appropriate staff members.
- Assist employees with routine personnel related questions as the first point of contact for employee related issues.
- Prepare and maintain list of evaluations due for appropriate departments.
- Work closely with Administrative Division Director in recruitment process.
- Prepare recruitment and selection materials as well as application packets and new employee orientation packets.
- Ensure that job announcements are posted and logged.
- Distribute application packets to applicants and assist with routine recruitment related questions.
Education
Bachelor of Arts (BA) - Business Administration specialization in Marketing
St. Thomas University
Miami, FLSkills
- HIPAA compliance
- Provider enrollment
- Application processing
- Audit preparation
- Credential verification
- Policy interpretation
- Problem-solving
- Time management
- Attention to detail
Timeline
Provider Enrollment Analyst
BlueCross Blue Shield of South Carolina
11.2024 - Current
Quality Assurance Analyst
Teleperformance
01.2021 - 09.2023
Permit Services Specialist
City of Hollywood
10.2016 - 12.2020
Front Office Specialist/Physical Therapy Tech
Concentra Urgent Care
05.2012 - 11.2016
Quality Assurance Support/ Human Resources Assistant
St. Albans Child Enrichment Center
10.2007 - 05.2012
Bachelor of Arts (BA) - Business Administration specialization in Marketing
St. Thomas University
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