CV / English / Claims Quality Assurance Manager
Personal Information
- Name: Sam Reynolds
- Address: 3475 Quiet Valley Lane, Silver City, NM, 88061
- Phone: (555) 342-9876
- Email: [email protected]
Brief
A dedicated and results-driven Claims Quality Assurance Manager with over 8 years of experience in implementing quality control systems, managing teams, and optimizing processes within the insurance industry. Proven track record of enhancing the accuracy and efficiency of claims processing through strategic quality assurance practices. Committed to maintaining the highest standards of compliance and performance.
Core Competencies
- Quality Assurance Systems
- Claims Management
- Team Leadership and Training
- Process Improvement
- Regulatory Compliance
- Performance Analysis
- Risk Management
- Customer Service Excellence
Technologies and Certifications
- Expert in MS Office Suite (Word, Excel, PowerPoint)
- Proficient in Claims Management Software (e.g., Guidewire, ClaimCenter)
- Certified Quality Auditor (CQA)
- Certified Manager of Quality/Organizational Excellence (CMQ/OE)
- Six Sigma Green Belt
Professional Experience
Global Insurance Corp., Albuquerque, NM
Claims Quality Assurance Manager (June 2016 – Present) - Led a team of 10 QA analysts in monitoring and analyzing claims processing to ensure compliance with internal and external standards. - Implemented a comprehensive quality assurance program that reduced processing errors by 30%. - Conducted regular training sessions for claims staff to enhance their understanding of compliance requirements and quality standards.
Regional Insurance Services, Santa Fe, NM
Quality Assurance Analyst (March 2014 – May 2016) - Assisted in the development and execution of quality assurance strategies that improved claim accuracy by 25%. - Played a key role in the audit process, identifying areas for improvement and collaborating with the claims processing team to implement fixes. - Managed the tracking of key performance indicators to assess the effectiveness of quality control measures.
Education and Training
- MBA, Focus in Quality Assurance, University of New Mexico, Albuquerque, NM, 2012
- B.S. in Business Administration, New Mexico State University, Las Cruces, NM, 2010
- Ongoing professional development in quality assurance methodologies and claim management systems.
Referees
Available upon request.