Janelle Gonzalez-Vega
Claims Quality Analyst @Driscoll Health Plan
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WORK HISTORY
Claims Quality Analyst @Driscoll Health Plan
US
As a Claims Quality Analyst, I review and audit medical claims to ensure accuracy, compliance, and alignment with payer and regulatory guidelines. I identify trends, correct errors related to coding, billing, and eligibility, and provide feedback to support continuous quality improvement. My role helps reduce claim denials, improve processing accuracy, and support timely reimbursement while maintaining compliance standards.
EDUCATION
Texas A&M University-Corpus Christi
Bachelor's degree, Health/Health Care Administration/Management
Texas A&M University-Corpus Christi
Master's degree, Business Administration and Management, General
ABOUT JANELLE GONZALEZ-VEGA
Claims Quality Analyst at Driscoll Health Plan with background in patient access and emergency care support, with a strong understanding of insurance workflows and quality standards.Health Administration graduate with a minor in Psychology and MBA candidate, certified in HR as a Strategic Business Partner. Active leader and volunteer with the American Heart Association and Making Strides Against Breast Cancer, with experience coordinating teams and supporting community health initiatives.Detail-oriented, reliable, and people-focused, with interests in healthcare operations, quality, and human resources.
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