Open to opportunities

Michelle Serrano

@michelleserrano

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Detail-oriented Quality Assurance professional with healthcare experience.

United States

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What I'm looking for

I am looking for a remote role that values quality and compliance, fosters collaboration, and offers opportunities for professional growth.

I am a dedicated Quality Assurance professional with over 8 years of experience in healthcare operations, patient advocacy, and quality auditing. My career has been marked by a commitment to enhancing service delivery and maintaining high standards of quality and compliance. I thrive in remote environments where I can leverage my analytical and communication skills to make a positive impact.

In my most recent role as a Quality Assurance Specialist at Ensemble Health Partners, I evaluated team interactions to ensure alignment with quality standards and compliance policies. I played a pivotal role in creating QA scorecards and training materials, collaborating with leadership to analyze performance data and recommend improvements. My previous experience as a Clinical Quality Assurance Coordinator further honed my skills in conducting thorough quality reviews and ensuring adherence to regulatory standards.

Throughout my career, I have consistently demonstrated strong communication skills and a compassionate approach to patient advocacy. I am passionate about using my expertise to contribute to continuous improvement in healthcare quality and patient satisfaction.

Experience

Work history, roles, and key accomplishments

Quality Assurance Specialist

Ensemble Health Partners

Apr 2020 - Mar 2024 (3 years 11 months)

Evaluated and scored team interactions with patients, healthcare providers, and insurance payers to ensure alignment with company quality standards, compliance policies, and exceptional service expectations. Monitored and reviewed Revenue Cycle communications, identifying adherence to scripting, empathy, accuracy, and professionalism.

Quality Assurance Compliance Performance Analysis Training Development Data Analysis Communication Microsoft Office Suite Root Cause Analysis Performance Metrics

Clinical Quality Assurance Coordinator

Revenue Group

Oct 2021 - Oct 2022 (1 year)

Conducted thorough quality assurance reviews of peer review reports, correspondences, and supplemental documents to ensure clarity, clinical accuracy, and adherence to client-specific requirements. Verified that all medical rationales were evidence-based, clearly articulated, and supported by current, reputable clinical references and guidelines.

Quality Assurance Regulatory Compliance Documentation Client Relations Data Analysis Communication Microsoft Office Suite Root Cause Analysis Performance Metrics

Patient Advocate

PrudentRx

May 2020 - Nov 2020 (6 months)

Handled high-volume inbound and outbound calls to welcome members into the PrudentRx program and assist them with enrollment in drug manufacturers' copay assistance programs. Maintained accurate and detailed documentation of patient information, medications, employer details, and pharmacy data in Salesforce per strict departmental guidelines.

Patient Advocacy Salesforce Communication Data Entry Documentation Customer Service Time Management

Enrollment Specialist

Fischer Services

Jun 2015 - Jun 2019 (4 years)

Processed Medicare applications received via fax, email, and in person, ensuring timely and accurate handling of sensitive enrollment documents. Entered a large volume of patient, provider, and insurance agent data into the company CRM system with a high degree of accuracy and attention to detail.