Simera Professional Key (SPK)

Manuel Alejandro B

Peru

Claims QA Specialist

$ 4,200/month

5 yrs exp

Hi, my name is Manuel Barreto. I have around three and a half years of experience in claims operations, data entry, and quality assurance. I started my career as a Senior Claims Administrator, where I learned the claims process and developed strong attention to detail. Then, I worked as a Data Entry Specialist, processing more than 120 files per day while maintaining high accuracy. I was also recognized as Employee of the Month several times because of my performance. Currently, I work as …

Skills

  • Business Process Improvement
  • Career Management
  • Cash Management
  • Change Management
  • Critical Thinking
  • Problem Solving
  • Quality Center
  • Sales Management
  • Talent Management
  • Calendar Management
  • Case Management
  • Cost Management
  • Costs Management
  • CRM Management
  • Data Management
  • Database Management
  • Process Improvement Analysis
  • Quality Assurance
  • Process Improvement
  • Reporting and Documentation
  • Problem-Solving
  • Cross-functional Collaboration
  • Data Quality Assurance
  • Quality control
  • Client Management
  • Data Entry & Document Management
  • assets management
  • Probelm Sloving
  • Problem Solver
  • Change Management.
  • Problem-Solving:
  • dataentry
  • Problem-solving.
  • data intry
  • Quality contol
  • Document review
  • Problem - solving
  • Cross functional Collaboration
  • EMR data entry
  • Critial Thinking
  • Cross-Functional Team Collaboration
  • Claims Processing
  • System Management
  • Cross-functional Coordination
  • Crossfuntional Colaboration
  • Faxes Management
  • Cross-Functional Collaboaration
  • Cross-Cultural Collaboration
  • Cross-Functional Collaboration & Oversight
  • Process Improvement(SOPs)
  • Legal Case Management
  • Data Verification & Accuracy
  • Data Quality Control
  • Problem Saving
  • Quality Assurance (QA)
  • Case Manager
  • Data Entry & Management
  • o Problem-Solving
  • crtical thinking
  • Release Management
  • Documentation Review
  • Cross‑functional Collaboration
  • Issue Management
  • Agile & Process Improvement
  • Tme Management
  • waste management
  • Proble solving
  • Crises Management
  • process imoprovement
  • Data Entry & Records Management
  • Legal Document Review
  • Cross-functional Product Collaboration
  • Quality Assurance in ETD
  • Reporting & Documentation
  • 3. Problem-Solving
  • Data Entry & Record Management
  • Stakeholder & Cross-Functional Collaboration
  • Problem solving
  • Data Entry & Data Management
  • Cross-Functional Leadership & Collaboration
  • Cross-Functional Collaboration

Manuel Alejandro B

Peru

Claims QA Specialist

$ 4,200 /month

5 yrs exp

Hi, my name is Manuel Barreto. I have around three and a half years of experience in claims operations, data entry, and quality assurance. I started my career as a Senior Claims Administrator, where I learned the claims process and developed strong attention to detail. Then, I worked as a Data Entry Specialist, processing more than 120 files per day while maintaining high accuracy. I was also recognized as Employee of the Month several times because of my performance. Currently, I work as …

Skills

  • Business Process Improvement
  • Career Management
  • Cash Management
  • Change Management
  • Critical Thinking
  • Problem Solving
  • Quality Center
  • Sales Management
  • Talent Management
  • Calendar Management
  • Case Management
  • Cost Management
  • Costs Management
  • CRM Management
  • Data Management
  • Database Management
  • Process Improvement Analysis
  • Quality Assurance
  • Process Improvement
  • Reporting and Documentation
  • Problem-Solving
  • Cross-functional Collaboration
  • Data Quality Assurance
  • Quality control
  • Client Management
  • Data Entry & Document Management
  • assets management
  • Probelm Sloving
  • Problem Solver
  • Change Management.
  • Problem-Solving:
  • dataentry
  • Problem-solving.
  • data intry
  • Quality contol
  • Document review
  • Problem - solving
  • Cross functional Collaboration
  • EMR data entry
  • Critial Thinking
  • Cross-Functional Team Collaboration
  • Claims Processing
  • System Management
  • Cross-functional Coordination
  • Crossfuntional Colaboration
  • Faxes Management
  • Cross-Functional Collaboaration
  • Cross-Cultural Collaboration
  • Cross-Functional Collaboration & Oversight
  • Process Improvement(SOPs)
  • Legal Case Management
  • Data Verification & Accuracy
  • Data Quality Control
  • Problem Saving
  • Quality Assurance (QA)
  • Case Manager
  • Data Entry & Management
  • o Problem-Solving
  • crtical thinking
  • Release Management
  • Documentation Review
  • Cross‑functional Collaboration
  • Issue Management
  • Agile & Process Improvement
  • Tme Management
  • waste management
  • Proble solving
  • Crises Management
  • process imoprovement
  • Data Entry & Records Management
  • Legal Document Review
  • Cross-functional Product Collaboration
  • Quality Assurance in ETD
  • Reporting & Documentation
  • 3. Problem-Solving
  • Data Entry & Record Management
  • Stakeholder & Cross-Functional Collaboration
  • Problem solving
  • Data Entry & Data Management
  • Cross-Functional Leadership & Collaboration
  • Cross-Functional Collaboration

Claims QA Specialist

Simpluris
June 2025 - present

Conduct detailed quality assurance reviews of processed claims files to verify accuracy, completeness, and compliance with established procedures and quality standards. Document QA findings and maintain accurate quality-control records to support tracking, reporting, performance analysis, and continuous improvement. Prepare and maintain QA reports and performance metrics, providing visibility into quality trends, recurring errors, and areas requiring improvement. Provide feedback and guidance to team members on quality requirements, documentation standards, and proper claim-processing procedures. Manage high-volume review workloads while maintaining established productivity, accuracy, and quality standards.

Data Entry Specialist

Simpluris
January 2024 - May 2025

Accurately entered, updated, and maintained high volumes of data across internal systems and databases while preserving data consistency and integrity. Reviewed and validated information from multiple sources to identify discrepancies, missing data, and potential errors before submission. Performed data verification and quality checks to ensure records complied with established procedures, guidelines, and accuracy standards. Collaborated with internal teams to resolve data discrepancies, clarify missing information, and ensure timely completion of assigned tasks. Identified recurring data issues and supported process-improvement initiatives focused on improving accuracy and operational efficiency.

Claims Administrator

Simpluris
September 2022 - December 2023

Processed and reviewed documentation submitted by class action members to determine eligibility for payments and benefits according to established case requirements. Performed detailed data entry and validation of claimant information, ensuring records were complete, accurate, and properly documented. Managed high volumes of claimant records while meeting established productivity, accuracy, and turnaround-time expectations. Reviewed claim documentation and case information to identify missing or inconsistent information requiring resolution. Applied SOPs, case-specific procedures, and eligibility requirements to ensure consistent and compliant processing.

Administrative Support Advisor

Instituto Nacional de Salud
March 2022 - May 2022

Provided administrative and operational support, including document management, information organization, and record maintenance. Reviewed and organized administrative documentation to ensure accuracy, completeness, and accessibility. Maintained accurate records and supported day-to-day administrative operations.

Specialist Advisor

AMG LLC
October 2021 - January 2022

Provided customer support and resolved inquiries through effective communication and problem solving. Handled multiple customer requests while maintaining service quality and professional communication.

Marketing Assistant

Acero Estudio Latam SAC
April 2021 - October 2021

Supported the execution of marketing campaigns and day-to-day marketing operations. Coordinated information and documentation required for marketing initiatives.

Food & Beverage Assistant

Bear Valley Alpine Country Resort
December 2018 - March 2019

Provided customer service in a fast-paced food and beverage environment.

Smart Scores

Communication
85
Role Fit
85
Adaptability
78
Problem-solving
80

Smart Skills

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