Sade Jordan
@sadejordan
Diligent Quality Assurance Analyst with expertise in process improvement.
What I'm looking for
I am a dedicated Quality Assurance Analyst and Process Improvement Specialist with over 7 years of experience in the medical and pharmacy sectors. My journey began as a Reimbursement Lead, where I honed my skills in identifying problems and implementing effective solutions. I take pride in consistently meeting deadlines and service level agreements (SLAs) for various clients and pharmaceutical hubs over the past four years.
In my current role as a Pharmacy Billing QA Analyst, I manage a team of over 60 agents across two client-based programs. I excel in monitoring and scoring agent calls, running reports, and presenting data to clients. My proficiency in tools like Salesforce, EPIC, and Tableau Analytics allows me to compile data effectively for year-to-date reports. I am passionate about mentoring and coaching employees to ensure best practices are followed, and I continuously seek to identify program enhancements and operational efficiencies.
Experience
Work history, roles, and key accomplishments
Quality Assurance Analyst/Process Improvement Specialist
UBC
Oct 2023 - Present (1 year 8 months)
Monitored over 60 agents across two client-based programs, ensuring adherence to quality standards and client expectations. Conducted client calibrations and presented data-driven insights to improve program performance.
Reimbursement Specialist Lead
UBC
Aug 2022 - Oct 2023 (1 year 2 months)
Ensured HCP reimbursement by verifying and obtaining accurate benefits, demonstrating a thorough understanding of Medicaid and Medicare policies. Mentored and coached employees, identifying and implementing program enhancements and operational efficiencies.
Patient Access Specialist Lead
Assist Rx
May 2021 - Aug 2022 (1 year 3 months)
Reviewed claims to ensure compliance with payor-specific billing requirements and identified optimal care passages for patients. Verified health insurance eligibility and obtained benefit information, while assisting with medical records requests.
Authorization Specialist
Accredo Health Group
Sep 2020 - May 2021 (8 months)
Obtained prior authorizations from payers, ensuring compliance with requirements and maintaining accurate records within the EMR. Processed referrals and submitted medical records to expedite the prior authorization process.
Pharmacy Service Representative Lead
CVS Health
Sep 2018 - Aug 2020 (1 year 11 months)
Coached teammates and conducted quality audits to enhance productivity and efficiency. Processed and reviewed prior authorization requests, interpreting medical and pharmacy data for accurate system entry.
Education
Degrees, certifications, and relevant coursework
Seminole State College
Healthcare Administration
Studied Healthcare Administration. Gained knowledge in managing healthcare systems and operations.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
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