Quality Assurance Insurance

Natalie Quiñones

*** *. ****** ***. *** #* Montebello, CA

818-***-**** • ********.********@*****.***

EDUCATION

Pasadena City College Pasadena, CA Anticipated August 2017

Associate of Arts: Psychology

GPA 3.50/4.00

Courses completed in: Psych 101, Neuropsychology, Developmental Psychology, Abnormal Psychology, and Child Development.

EXPERIENCE

Artemis Hill Recovery Inc. Huntington Beach, CA

Quality Assurance, Accounting Analyst September 2016 - Present

• Compile monthly trend reports in order to analyze areas that are in need of improvement

• Review client files for proof of medical necessity for billing purposes

• Audit client files for errors and non-compliance issues regarding all documentation

• Communicate with staff and directors to ensure all proper training for employees is completed

• Generate Utilization Review reports to ensure clients receive coverage for their length of treatment

• Correspond with insurance companies regarding outstanding claims

• Follow up on any refund requests or denials regarding insurance claims

• Maintain and update aging report

Growth Management Inc. Pasadena, CA

Quality Assurance, Executive Assistant July 2014 – June 2016

• Reviewed and edited documentation for current census at all facilities

• Analyzed individual/conjoint therapy notes for grammar, content, and compliance with insurance criteria

• Communicated with program managers to ensure documentation is completed accurately and on time

• Created training manuals for new employees

• Completed billing for medication co-pays, intake fees, and other uncovered insurance costs

• Audited all facility billing using the Aging Summary for each location

• Thoroughly reviewed client’s billing information to ensure they were billed for correct LOC/attendance

• Assisted with billing phone calls and taking designated messages

VOLUNTEER EXPERIENCE

Midnight Mission Los Angeles, CA February 2017

●Organized a clothing and supply drive for the homeless through community outreach

Skills and Office Program Knowledge

Attention to detail, formal knowledge of proper protocol, familiarity with HIPAA procedures, grammar and spelling proficiency, phone etiquette, crisis management, discharge planning, account reconcilement, training, managing schedules, collecting outstanding balances, and communicating via phone and email with financially responsible parties.

• Microsoft Office.

• Quickbooks

• Sigmund

• EdgeMED

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