Open To Work
Shannon Colbert
Sr. Quality Coach
Granite City,IL
Work Preference
Job Search Status
Open to workDesired start date: 2 weeks notice
Work Type
Full TimeLocation Preference
RemoteSalary Range
$55000/yr - $100000/yrImportant To Me
Healthcare benefitsWork from home optionPaid time off401k matchFlexible work hoursSummary
Seasoned Quality Coach recognized for high productivity levels and efficient task completion. Skilled in developing comprehensive quality assurance protocols, performance improvement strategies, and employee training programs. Excel in communication, problem-solving, and leadership, ensuring seamless operations and team cohesion. Committed to fostering environments that encourage continuous improvement and operational excellence.
Overview
17
17
years of professional experience
1
1
year of post-secondary education
Work History
Sr. Quality Coach
Dearborn Group
Belleville, IL
02.2022 - Current
- Conduct monthly employee audits to ensure compliance with company policies and industry regulations.
- Work with new hires their first 2 months released from training, including conducting weekly one on one and group meetings.
- Mentor/coach employees as needed based on their quality scores.
- Reviewed processes and provided feedback for continuous improvement initiatives.
- Collaborated with cross-functional teams to address quality issues promptly.
- Assisted in implementing new quality measurement tools and techniques.
- Analyzed data to identify trends and recommend process adjustments.
- Created and maintained detailed records of quality assurance activities.
- Participated in external audits conducted by regulatory bodies or third party organizations.
- Collaborated with cross-functional teams to develop and implement process improvements.
Dental Claims Examiner
Dearborn Group
Belleville, IL
01.2011 - 02.2022
- Reviewed dental claims for compliance with policy guidelines.
- Analyzed claim documentation for accuracy and completeness.
- Coordinated with dental providers to resolve claims disputes.
- Processed original entry dental claims
- Followed HIPAA guidelines
- Adjusted claims as needed
- Investigated complex or unusual cases that required additional research before determining final payment amounts.
- Performed data entry of dental claim information into the system for processing.
- Reviewed and analyzed dental claims for accuracy, completeness, and compliance with insurance policies and procedures.
- Maintained knowledge of current dental industry trends, including changes in regulations, coding systems, reimbursement policies.
- Sent clinical request and missing information letters to obtain incomplete information.
- Used contract notes and processing manual to correctly apply group-specific classifications to claims.
- Administered standard contract benefits to process pending claims for dental benefits.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Examined claims, records and procedures to grant approval of coverage.
- Prepared and reviewed insurance-claim forms and related documents for completeness.
- Organized information by using spreadsheets, databases or word processing applications.
Customer Service Advocate
Dearborn Group
Belleville, IL
01.2009 - 01.2011
- Educated customers on policies to ensure compliance and understanding.
- Upheld privacy and security requirements for customer information.
- Adhered to all company guidelines when interacting with customers.
- Managed incoming calls from customers in a professional manner.
- Provided accurate, valid, and complete information to customers in a timely manner.
- Followed up on customer inquiries not immediately resolved.
- Developed relationships with customers through friendly conversations.
- Maintained records of customer interactions and transactions.
- Utilized problem solving skills to resolve customer issues quickly and efficiently.
- Completed continuing education and training programs for professional development.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
- Provided benefit and claim information to enhance customer understanding.
Education
Paralegal Studies
06.2007 - 06.2008
Skills
- Quality auditing
- Compliance management
- Claims processing
- Cross-functional collaboration
- Problem solving
- Team mentorship
- Effective communication
- Attention to detail
- Relationship building
- Customer focus
- Teamwork and collaboration
- Adaptability
- Quality assurance
- LEAD certified
Timeline
Sr. Quality Coach - Dearborn Group
02.2022 - Current
Dental Claims Examiner - Dearborn Group
01.2011 - 02.2022
Customer Service Advocate - Dearborn Group
01.2009 - 01.2011
South Western Illinois College - , Paralegal Studies
06.2007 - 06.2008
Granite City High School - ,