Chanae S.
Healthcare Administration/ Health Information Management
- Role
- Quality Assurance Specialist at Prime Therapeutics
- Location
- Raleigh-Durham-Chapel Hill, NC, US
- LinkedIn followers
- 500 followers
About Chanae S.
I’m a healthcare professional with over 10 years of experience working at the…
Experience
Quality Assurance Specialist
May 2024 — Present
Tested and validated benefit plans for Prime, ensuring compliance with client specifications and quality standards.Collaborated with the AIS team throughout the plan-building process to verify accurate implementation of benefit configurations.Reviewed multiple systems to assess plan accuracy, identifying any discrepancies or issues in claim adjudication.Communicated with internal teams to report plan deficiencies, coordinating corrections with the AIS team for resolution.Maintained a scorecard to track performance and adherence to quality benchmarks post-training.Consistently achieved weekly goals, completing quality assurance reviews for 25 benefit plans with a high level of accuracyand attention to detail.Ensured compliance with operational procedures and maintained a strong focus on detail, avoiding errors in benefit plan setup and claim processing.
Education
Western Governors University
Master of Health, Healthcare Administration
Tidewater Community College
Associate of Science, General Studies
Norfolk State University
Bachelor of Science, Health Services/Allied Health/Health Sciences, General
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