Wendy Governale
Homeland
Summary
Quality and Process Improvement Analyst with 15+ years in insurance and financial services, known for turning data into action that elevates service quality, strengthens claims accuracy, and scales QA programs. Led LLM prompt engineering for automated quality assessments, improving scoring precision and pre-production-increasing audits per CSR. Revamped the QA scorecard to align with the AI model and internal standards. Strong at cross-functional delivery, stakeholder alignment, and front-line coaching to drive sustainable performance.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Quality Process Improvement Analyst II
Mercury Insurance
CA
01.2025 - Current
- Own the idea-intake portfolio: triaged submissions, route projects to the right teams, maintain status logs, and run a weekly prioritization cadence with leadership
- AI-enabled QA leadership (Lighthouse): served as QPI lead, gathered requirements for the vendor, coordinated UAT across call types, and independently audited ~160 calls to validate outputs-identifying empathy accuracy at 25% vs. an 89% vendor claim and driving corrective actions.
- Framework design and calibration: created a universal soft-skills rubric, consolidating categories from 10 to 5 (50% reduction) to improve clarity, inter-rater reliability, and alignment with AI scoring.
- Team enablement and process leadership: directed QPI teammates on new processes, assigned/monitored work to deadlines, led calibrations, and partnered with Training/Change Management to embed updates into workflows
- Prompt engineering: built and iterated LLM prompts (ChatGPT) for Claims, Billing, Customer Service, Customer Relations and UW Triage use cases; refined classifications and scorecard prompt to improve scoring precision and category accuracy.
Quality Call Center
Mercury Insurance
CA
01.2023 - 01.2025
- Completed 595 audits and 137 side-by-sides (s/s) for the year; sustained 16.68 observations per rep YTD, meeting the team goal.
- Delivered strong completion rates in peak quarters (up to 90% of planned audits and 97% of planned s/s); exceeded s/s plan by 370% in Q1 to accelerate coaching impact.
- Maintained productivity amid higher CSR-to-coach ratios, a teammates retirement, training, and special projects by adjusting cadence and collaborating for coverage.
- Reallocated capacity in Q4 to lead priority initiatives while coordinating backfill support; kept team performance on track against modified audit and s/s goals.
Claims Examiner
Mercury Insurance
CA
12.2019 - 01.2023
- Examined and documented complex BI files (≈80% litigated), ensuring accurate transactions, reserve/authority compliance, Medicare requirements, and audit-ready documentation; recognized as a go-to for complex, time-sensitive matters.
- Produced clear case reports for leadership with findings and recommendations; partnered with counsel and leaders on corrective actions and strategy.
- Drove strong performance at scale: sustained 90-100%+ closing ratios while absorbing bulk transfers; accelerated cycle time with high 30-day settlements; reduced average cost per claim by ~7% (monthly low ≈$4.7K).
- Mitigated legal exposure: maintained zero-to-litigation streaks on segments; secured a defense verdict (past meds ≈$9.8K) and a $0 settlement through targeted negotiation strategy.
Claims Adjuster II
Mercury Insurance
CA
12.2019 - 01.2023
- Maintained a low pending (~61 files) while delivering top-tier customer metrics: OPS 96.4% (28 surveys), NPS 85.7%, PCB 100%.
- Quality results: 93.82% YTD audit score (vs. ~90.3% branch avg); CARS 75% YTD (vs. 67-70% branch avg).
- Stepped up as a team leader-by-influence: covered senior adjuster workload during leave and took on complex files.
- Broadened exposure: handled UMBI, pedestrian, and motorcycle losses; secured multiple policy-limit settlements with additional cases progressing toward closure.
- Training and enablement: shared best practices in unit meetings; coached peers 1:1 on survey scripting and templates; supported branch engagement initiatives (e.g., virtual events).
Bank of America
Brea
10.2008 - 05.2013
- 10 years of lending, operations, quality, training, and collections in mortgage servicing.
- Led a team of 10-15 in First Mortgage operations; strengthened compliance discipline and improved audit outcomes.
- Designed and delivered onboarding/training as an SME across multiple sites; supported quality monitoring and reduced time-to-proficiency.
- Built productivity and quality reports to track operational flow and loan accuracy, coached mentors and standardized processes.
- Advised clients on mortgage products and guided relationship managers; achieved strong recovery results while educating customers on repayment options.
Education
Bachelor's Degree -
University of Phoenix
Skills
- Quality & Process Improvement
- Cross-Functional Project Leadership
- Data Analysis & Audit Development
- Training & Coaching
- Customer Experience Strategy
- Artificial Intelligence and Prompt Writing
- Word
- Excel
- Power BI
- Jira
- Visio
- Miro
- Sara
- Open AI
- Chat GPT
- Power Automate
- SharePoint Design
- Verint
Certification
- Instructional Design Essentials, Completed
- Business Process Improvement, Completed
- Learning Design Thinking, Completed
- Google Project Management, In Progress, 10/01/25
- Prompt Engineering, In Progress
Professional Overview
Quality and Process Improvement Analyst with 15+ years in insurance and financial services, known for turning data into action that elevates service quality, strengthens claims accuracy, and scales QA programs. Led LLM prompt engineering for automated quality assessments, improving scoring precision and pre-production increasing audits per CSR. Revamped the QA scorecard to align with the AI model and internal standards. Strong at cross-functional delivery, stakeholder alignment, and front-line coaching to drive sustainable performance.
Timeline
Quality Process Improvement Analyst II
Mercury Insurance
01.2025 - Current
Quality Call Center
Mercury Insurance
01.2023 - 01.2025
Claims Examiner
Mercury Insurance
12.2019 - 01.2023
Claims Adjuster II
Mercury Insurance
12.2019 - 01.2023
Bank of America
10.2008 - 05.2013
Bachelor's Degree -
University of Phoenix