Quandra Bines

Operations and team leader with 19+ years managing production, warehouse, and benefits/claims teams of up to 50 employees, plus hands-on pharmacy benefit investigation, prior authorization, and Medicare Part B experience. Data-driven supervisor who hires, trains, and coaches staff and holds teams to KPI, quality, and attendance targets in remote and ISO 9000-certified environments.

Billing Specialist / Escalations Lead - Duke Energy - Remote

(2024-02)

• Resolve high-priority billing disputes and account discrepancies as the escalation point for the team, closing over 200 cases per week with 30% resolved on first contact.
• Analyze account and payment data to identify recurring errors, then recommend process fixes that cut repeat escalations by 60%.
• Coach teammates on escalation handling, account research, and customer de-escalation.
• Maintain audit-ready electronic records for payments and autopay enrollments while protecting sensitive banking data.

Pharmacy Benefit Specialist - Prime Therapeutics - Remote

(2023-06 - 2024-02)

• Coordinated with insurers to obtain clinical information and verify coverage, supporting prior authorization and benefit determinations.
• Reviewed prior authorization and denial data to find root causes, and recommended process changes that improved approval turnaround.
• Verified ICD-10 and HCPCS coding accuracy in medical documentation to keep reimbursements compliant with Medicare Part B guidelines.

Warehouse / Production Operations Manager - Sunland Logistics Solutions

(2020-05 - 2023-12)

3PL, OEM parts manufacturing

• Led up to 50 employees across warehouse and punch brake production operations, setting daily staffing plans and priorities from production and inventory data.
• Hired, onboarded, and trained 30 employees, building a stable team.
• Used KPI and production data to plan workflows and allocate labor, raising output by 40% and on-time shipments to 90%.
• Directed inventory control and audits, cutting stock discrepancies and keeping electronic records correct.
• Maintained quality compliance for OEM parts under ISO 9000 certification, including documented work instructions and procedures.

Site Operations Manager - VTL Precision

(2019 - 2021)

• Managed site operations and a team of 45 staff members running mills, lathes, and robotic machinery for ISO 9000-certified OEM parts production.
• Hired and trained machine operators and technicians, shortening time to full productivity to 2 weeks.
• Used production and inventory data to schedule work and procurement, improving on-time delivery.
• Ran regular site inspections and process audits to maintain safety and regulatory compliance, and managed contractors to complete projects on schedule and within budget.

Bonding Production Manager - Spirit AeroSystems

(2012-01 - 2018-06)

• Led 30+ employees in a cleanroom, GMP-regulated aerospace bonding operation, managing scheduling, training, performance, and attendance.
• Drove production decisions with SAP and Maximo data, improving throughput and reducing rework by 85%
• Oversaw production tied to 5-axis and 7-axis machining under ISO 9000 quality standards for OEM aerospace parts.

Claims Benefits Specialist / Team Lead - Convergys - Remote

(2007-01 - 2018-06)

• Led a team of 7 claims specialists, monitoring quality and productivity metrics and coaching to targets.
• Prepared Medicare Part B cases for payment and clinical medical review, researching ICD-10 manuals and electronic medical records to validate determinations.
• Reviewed HCPCS coding and medical documentation for claims processing and denial management, improving accuracy.
• Advised the team on clinical, coding, and health insurance legislation questions.

MBA/MHA - Dual Degree - University of Phoenix (2027)

Bachelor of Science - Business Administration and Operations - University of Phoenix (2025-12)