
Operations professional with over 10 years of experience achieving 100% quality assurance in case coordination and compliance operations. Expertise in performance reporting, operational analysis, and process enhancement to improve efficiency and service quality. Recognized for enhancing operational stability, ensuring data integrity, and maintaining strict regulatory standards in high-volume environments.
Achieved 100% monthly QA scores, ensuring documentation accuracy and regulatory compliance in high-volume operations.
Managed end-to-end EAP case coordination across complex member cases, including intake and provider scheduling.
Conducted risk assessments, ensuring adherence to safety protocols and escalation standards.
Maintained workflow continuity during peak periods through effective management of member and provider communications.
Provided support to peers regarding workflow clarification, QA alignment, and best practices.
Collaborated with quality and reporting teams to enhance process accuracy and turnaround efficiency.
• Scheduled UHC member appointments while maintaining strict TAT compliance and documentation accuracy.
• Conducted outbound outreach to educate members and improve appointment acceptance rates.
• Managed provider alignment and ensured data accuracy within system workflows.
• Adapted to pilot programs and evolving operational processes with minimal supervision.
• Maintained high productivity standards in fast-paced scheduling environments.
• Managed service operations for enterprise clients including Trane and Avis Budget Group.
• Created and resolved service tickets from shared mailboxes ensuring timely issue resolution.
• Selected for pilot voice-based billing support due to strong communication performance.
• Processed vendor billing, invoice validation, and payment coordination with accuracy.
• Maintained data integrity and ensured timely ticket closure through proactive follow-ups.
Senior Operations & Case Management Professional | Quality Assurance | Compliance | Provider coordination | Process Optimization