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Palmetto Gba - Senior Quality Analyst Resume Example

Jacob Jones
XXXX XX XX X, South Portsmouth, KY 41174
Ph: XXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXX
Professional Summary
I have 27 years of work experience with Palmetto GBA, an organization which processes and audits medicare claims.  For the past three years I served as a Senior Quality Analyst. I served with the Appeals department for four years, and a claims analyst for 19 years.  My skills and experiences include: auditing, budgeting, database administration, policy analysis, multi-tasking, analyzing medical claims data and retrieving electronic documents for processing.  My job previous to this for 2 years at Hilltop Health Center I was a Receptionist/interviewee and I interviewed clients to see if they qualified to be eligible to receive medical and food assistance and the WIC program. Arranged transportation for clients.  I also set up additional appointments for clients if needed.  Previous to this job I worked for Attorney Richard Hunter for one year as the receptionist  I interviewed clients, handled all incoming and outgoing phone calls.  Typing, dictation.  Interviewed clients and scheduled appointments.
Skills

Microsoft Office, Auditing, Budgeting, Database Administration.  Policy Analysis, spreadsheets, microsoft excel, microsoft word, qualtrack, secretarial.  ICD-9 Medical Coding, Procedure codes, coding claims.  Excellent witten and verbal communications skills.  Appeals processing, telephone skills, appeals interviews, general office equipment, multiline phone systems, scanners, general office duties,  , verbal communication skills and writing. Interviewer,  scheduling.

Experience
Senior Quality Analyst Jun 1987Sep 2013 Palmetto GBA Wheelersburg, Ohio Conducted internal audits, audits of individuals, audits of an organization.  Developed auditing systems.  Collected and analyzed financial data.  Determined compliance with laws and regulations.  Detected problems like duplicated work, unnecessary spending, fraud, non-compliance with laws and regulations, non-compliance with management policies.  Interviewed workers about records and transactions.  Ensured resolution of audit findings and resolutions  Used database software, spreadsheet software  Audited large budgets including Medicare claims.
Receptionist/interviewee Jun 1985Jun 1987 Hilltop Health Center Columbus, Ohio Interviewed clients to see if they qualified to be eligible to receive medical and food assistance.  This was a government funded office.  We provided medical services. applications for the WIC Programs and applications for the food assistance programs.  Arranged transportation for the clients if needed.  I interviewed the clients to see if they qualified for the programs.  Set up additional appointments for the clients.
Receptionist May 1983May 1984 Attorney Richard Hunter Portsmouth, Ohio Front desk receptionist.  I interviewed clients, handled all incoming and outgoing phone calls.  Performed typing and dictation (this was before computers existed)  I interviewed all clients in person.  If they met the criteria I would then schedule an appointment for them with the attorney.
Education
High School Diploma May 1983 Greenup County High School Greenup, KY I also have a year of executive secretarial studies at Southeastern Business College- no degree.
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Resume Details

This is a real resume for a Senior Quality Analyst in South Portsmouth, Kentucky with experience working for such companies as Palmetto Gba, Hilltop Health Center, Attorney Richard Hunter. This is one of the hundreds of Senior Quality Analyst resumes available on our site for free. Use these resumes as templates to get help creating the best Senior Quality Analyst resume.

Previous Companies:

  • Palmetto GBA
  • Hilltop Health Center
  • Attorney Richard Hunter

Previous Job Positions:

  • Senior Quality Analyst
  • Receptionist
  • interviewee

Schools:

  • Greenup County High School

Level of Education:

  • High School Diploma

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