Briana Denkins
McLeansville
Summary
Highly motivated Quality Control Specialist with extensive experience in program compliance, document review, and data verification. Proven ability to manage federally funded programs, conduct thorough reviews, and maintain compliance with program policies and federal regulations. Adept at managing large volumes of applications, identifying discrepancies, and ensuring data accuracy. Recognized for strong analytical skills, attention to detail, and effective communication in fast-paced, remote environments.
Overview
10
10
years of professional experience
Work History
Housing Program Specialist- Closeout
North Carolina Office of Recovery & Resiliency
05.2021 - Current
- Conduct detailed eligibility reviews for federally funded programs, ensuring compliance with program policies and regulations.
- Verify the accuracy and completeness of applicant files, flagging discrepancies for further review.
- Collaborate with the auditing team on fraud investigations to identify and resolve discrepancies.
- Recommend process improvements to streamline workflows and enhance program accuracy and accountability.
Quality Control Specialist
CareMetx
05.2018 - 01.2021
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
- Developed and maintained quality assurance procedure documentation.
- Conducted high-level reviews of documentation to ensure compliance with program policies.
- Worked in a fast-paced environment, delivering results with minimal supervision while meeting tight deadlines.
Therapist
Amethyst Consulting & Treatment Solutions
09.2016 - 01.2018
- Maintained and updated patient records, changes in service plans and treatment reports.
- Guided clients in development of skills and cognitive behavioral therapy techniques.
- Counseled individuals, groups, and families to bring awareness of problems, deal with crisis situations and develop action plans.
- Documented patient information, treatment plans, and patient responses.
Senior Claims Representative
United Healthcare
10.2014 - 01.2018
- Updated field operations staff on status of open claims and current actions.
- Conducted investigations into complicated mid- and high-exposure claims.
- Recommended and set reserves based on expected payouts.
- Collaborated with legal department on important claims.
- Worked productively in fast-moving work environment to process large volumes of claims.
Education
Master of Social Work -
North Carolina A&T State University
Greensboro, NC05-2013
Bachelor of Science - Psychology
Fayetteville State University
Fayetteville, NC05-2011
Skills
- Quality Control & Compliance
- Document Review & Data Verification
- Policy & Procedure Adherence
- Process Improvement
- Fraud Investigation Support
- MS Office Suite & Adobe Reader Proficiency
Timeline
Housing Program Specialist- Closeout
North Carolina Office of Recovery & Resiliency
05.2021 - Current
Quality Control Specialist
CareMetx
05.2018 - 01.2021
Therapist
Amethyst Consulting & Treatment Solutions
09.2016 - 01.2018
Senior Claims Representative
United Healthcare
10.2014 - 01.2018
Master of Social Work -
North Carolina A&T State University
Bachelor of Science - Psychology
Fayetteville State University
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