Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Mary Angeli Bano

Talisay City

Summary

Experienced Quality Auditor with a strong background in quality assurance and management. Over 9 years of experience in improving call quality, increasing customer satisfaction, and optimizing audit procedures. Adept at encouraging colleagues, providing effective feedback, and implementing process improvements. Known for a keen eye for detail, strong analytical skills, and a dedication to excellence. Eager to contribute my skills and leadership to the role of Quality Supervisor to enhance operational efficiency and team performance.

Overview

14
14
years of professional experience
1
1
Certification

Work History

Clinical Quality Auditor

Optum
04.2016 - Current
  • Investigated call and case samples for any errors incurred during processing
  • Provided detailed feedback and coaching to coordinators to improve performance and adherence to quality guidelines
  • Generated comprehensive reports on audit findings and presented them to management for strategic decision-making
  • Identified areas for process improvement and implemented changes to enhance workflows
  • Facilitated calibrations and Quality talks in partnership with Operations and Business Quality leaders

Claims Rep Associate

UHC
04.2012 - 04.2016
  • Determined claim coverage utilizing provided resources such as claims bulletins, state variations and applicable contracts
  • Utilized CPT, ICD-10 and other coding systems in the medical billing process
  • Verified any unclear information and requests medical records through phone calls for claims which need further investigation
  • Handled appeals, requests, rebuttals from insureds and providers, sending appropriate response through letters or phone calls

Claims Data Encoder

UHC
09.2011 - 04.2012
  • Entered claimant data by inputting alphabetic and numeric information on keyboard
  • Maintained data entry requirements by following data program techniques and procedures
  • Reviewed data for deficiencies, resolving discrepancies by using standard procedures or returning incomplete documents to the team lead for resolution

Education

Bachelor of Science - Nursing

Cebu Normal University
Cebu, Philippines

High School Diploma -

Cebu City National Science High School
Cebu, Philippines

Elementary Education -

Saint Theresa’s College
Cebu, Philippines

Skills

  • Quality Assurance: Proficiency in quality monitoring and auditing processes
  • Data Analysis: Ability to analyze performance metrics and generate actionable insights
  • Process Improvement: Experience in identifying and implementing process enhancements
  • Reporting: Skilled in creating detailed reports and presentations for management
  • Training and Development: Expertise in developing and delivering new auditor onboarding programs
  • Effective Communication: Excellent verbal and written communication skills
  • Customer Service: Strong understanding of customer service principles and practices
  • Time Management: Ability to manage multiple tasks and prioritize effectively
  • Attention to Detail: Keen eye for detail to ensure accuracy and compliance
  • Microsoft Office: Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint)

Certification

  • Licensed Nurse - 2011 to Present
  • New Manager Program (NMP) Certified - May 2024 - May 2025

Timeline

Clinical Quality Auditor

Optum
04.2016 - Current

Claims Rep Associate

UHC
04.2012 - 04.2016

Claims Data Encoder

UHC
09.2011 - 04.2012

Bachelor of Science - Nursing

Cebu Normal University

High School Diploma -

Cebu City National Science High School

Elementary Education -

Saint Theresa’s College

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Mary Angeli Bano