Andres Solano

Details

Skills

Hard Skills

Healthcare Compliance: HIPAA Privacy & Security, PHI Handling, Medical Records Management.
Medical Software: Athena EHR, Navierre, Availity, Navinet, Payer Portals.
Quality Assurance: Call & Chat Monitoring, NICE Systems, Calibration Sessions, Standardized Scoring.
Process Methodology: Root Cause Analysis (RCA), Corrective and Preventive Actions (CAPA), SOP Development.
Data & Analytics: Advanced Excel (Pivot Tables, VLOOKUP), Google Sheets, KPI Tracking (NPS, AHT, CSAT), Dashboard Maintenance.
Financial & Regulatory: PCI DSS, AML Protocols, Fraud Prevention, Insurance Verification.
Systems & CRM: Salesforce, TSYS, Innovis, Avaya (VoIP), Microsoft Office Suite.

Soft Skills

Leadership: Team Leadership, Assertive Mentoring, Actionable Coaching.
Communication: Bilingual Proficiency (English/Spanish), Empathetic Communication, Conflict Resolution, Positive Language.
Management: High Attention to Detail, Strategic Planning, Time Management, Multitasking, Crisis Management.

Keywords

HIPAA, Athena EHR, NICE Systems, Quality Assurance, Medical Billing, Insurance Verification, RCA, CAPA, Salesforce, Data Integrity, Bilingual Support, Patient Intake, Prior Authorizations, PCI DSS.

About

Precision saves time. Compliance saves reputations. I do both.

With 8 years of experience in high-stakes environments—from Healthcare to Financial Services—I have built my career on a single premise: Operational excellence is only possible when clinical precision meets bulletproof compliance.

My Approach to Operations

As an Industrial Designer turned QA Expert, I look at workflows through a "systems-thinking" lens. I don't just audit tasks; I optimize ecosystems. My focus is on creating scalable processes where data integrity and regulatory adherence (HIPAA, PCI DSS, AML) are woven into the daily routine, not just treated as an afterthought.

Core Areas of Expertise:

Process Optimization: Expert at identifying friction points using Root Cause Analysis (RCA) and implementing CAPAs that actually stick.

Medical Ecosystems: Deeply experienced in Athena EHR, Availity, and the intricacies of US healthcare revenue cycles and prior authorizations.

Performance Leadership: I believe in assertive, data-driven coaching. My goal is always to bridge the gap between complex KPIs and human performance, fostering a culture of continuous improvement.

In my view, the most successful organizations are those that can balance empathetic service with strict compliance. I am dedicated to maintaining that balance, ensuring that every interaction is both professional and protected.

I believe data integrity should never come at the expense of human connection, but it must always remain non-negotiable.

Focus: Quality Assurance, Medical Operations, Process Auditing, Salesforce, HIPAA, RCA, Bilingual Leadership (EN/ES).

Where precision meets empathy, quality becomes a standard.