Customer Service Quality Control

Katherine Jones

***********@*****.*** 601-***-**** Jackson, MS

SUMMARY

Dedicated applicant with 1 year of experience in Medicaid program integrity and eligibility review, seeking a Medical Data/Billing Specialist role. Skilled in meticulous data verification, quality control, and customer service within healthcare settings. Holds an AA in Medical Billing and Healthcare Management, complemented by strong analytical abilities.

WORK EXPERIENCE

Half Shell Restaurant

Food Expeditor Oct 2023 - Present

• Facilitate timely and precise delivery of orders to guests' tables.

• Communicate customer orders effectively to kitchen staff for preparation.

• Inspect dishes to ensure adherence to restaurant food quality standards. Conduent

Medicaid Review Specialist Apr 2022 - Jul 2022

• Evaluated eligibility decisions for Medicaid and CHIP programs, ensuring adherence to state and federal laws, rules, and regulations.

• Conducted thorough reviews of information provided by beneficiaries to verify accuracy and maintain program integrity.

• Supported supervisory staff by examining case assessments performed by Medicaid Specialist levels I, II, and III, contributing to the quality control process.

Q3M Insurance Solutions

Call Center Agent Nov 2022 - Jan 2022

• Efficiently directed calls to update customer benefits during annual healthcare enrollment, adhering to company protocols.

• Provided comprehensive information to customers to prepare them for the transition to Medicaid Agent assistance.

• Maintained high standards of customer service, ensuring all inquiries were addressed with accuracy and clarity. EDUCATION

Unknown

Associate in Arts (AA), Medical Billing and Healthcare Management Aug 2021

CERTIFICATIONS

Medical Data Technology 2021

SKILLS

Problem-Solving Skills • Ability to Work in a Team • Strong Work Ethic • Analytical and Quantitative Skills

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