Virginia Beach, Virginia BeachMember since January 12, 2026
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About
Detail-oriented healthcare operations professional with 8+ years of experience in medical claims analysis, appeals coordination, and provider dispute resolution. Skilled in researching denied claims, interpreting authorization requirements, and drafting appeal determination letters in compliance with CMS and NCQA standards. Adept at navigating internal systems and vendor portals to ensure timely and accurate case handling. Passionate about improving member outcomes through empathetic communication and regulatory precision
Experience
Detail-oriented healthcare operations professional with 8+ years of experience in medical claims analysis, appeals coordination, and provider dispute resolution. Skilled in researching denied claims, interpreting authorization requirements, and drafting appeal determination letters in compliance with CMS and NCQA standards. Adept at navigating internal systems and vendor portals to ensure timely and accurate case handling. Passionate about improving member outcomes through empathetic communication and regulatory precision
Education
Masters in Business Administration
Bachelors in Business Administration
A.A.S in Health and Medical Administrative Services
