Quality Improvement & Compliance Auditor

Paula J Lynch

Plymouth, CT ***** 203-***-**** ***********@*********.***

Summary

Results-driven professional with expertise in quality auditing and process improvement. Known for meticulous attention to detail and effective communication skills, facilitating the resolution of quality issues and enhancing service standards across the organization.

Skills

Quality auditing

Data analysis

Process improvement

Compliance assessment

Report writing

Healthcare regulations

Effective communication

Problem solving

Attention to detail

Team collaboration

Experience

QUALITY IMPROVEMENT SPECIALIST 1 08/2021 - 08/2025 WellCare - New Haven, Connecticut

Maintained records management system to process personnel information and produce reports. Communicated with patients with compassion while keeping medical information private. Investigated customer complaints regarding product and service quality issues; documented findings and recommended corrective actions accordingly.

Provided guidance on Quality Improvement initiatives throughout the organization. Participated in external audits related to QI processes, providing evidence as needed. Reviewed customer feedback forms and used them as input when developing new strategies for improving services offered.

HEDIS AUDIT ASSOCIATE 01/2019 - 08/2021

Wellcare (The Judge Group) Temp agency - Hamden, Connecticut Conducted internal audits to assess compliance with financial regulations. Reviewed financial records for accuracy and completeness. Documented audit findings and prepared detailed reports for stakeholders. Assisted in the implementation of process improvements based on audit results. Coordinated with external auditors to facilitate annual audits efficiently. HEDIS AUDIT ASSOCIATE 01/2018 - 05/2018

Anthem - Wallingford, Connecticut

Conducted internal audits to assess compliance with financial regulations. Assisted in the implementation of process improvements based on audit results. Trained junior staff on auditing procedures and best practices. Interacted with clients to request information and relay to audit team. OFFICE MANAGER/RECEPTIONIST MANAGER 07/2016 - 05/2017 Dr. Wolf J Ehrlich, MD - Wallingford, Connecticut

Oversaw supply inventory and ordered office supplies as needed. Implemented office policies to enhance productivity and organization. Assisted in budgeting processes and monitored expense reports regularly. Trained new employees on office procedures and software systems effectively. Answered phone calls, responded to emails, routed mail and coordinated courier services. Tracked invoices and payments to ensure accuracy of accounts receivable and payable information. Monitored payments due from clients and promptly contacted clients with past due payments. Managed front desk operations including greeting visitors, answering questions or directing them to appropriate personnel.

Resolved customer inquiries in a timely manner while maintaining positive relationships with clients. Maintained impeccable office organization to support efficiency, professionalism and performance objectives. Supervised staff members, organized schedules and delegated tasks. Oversaw receiving and organizing correspondence, answering and forwarding calls and creating business letters and records.

Managed office budget to handle inventory, postage and vendor services. Education and Training

Porter & Chester Institute - Watertown, CT Associate of Science Administrative Healthcare Specialist, 07/2010

NWCCC - Winsted, CT Some College (No Degree)

Business Administration

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