Quatrina Brown-Donnings

Dedicated customer service professional with more than 10 years of experience supporting healthcare members and providers in fast-paced office and remote environments. Skilled in handling customer inquiries, researching and resolving complex issues, documenting interactions accurately, and navigating multiple systems simultaneously. Proven ability to explain healthcare information clearly while demonstrating empathy, professionalism, sound judgment, and a consistent focus on positive outcomes.

Experienced in Medicare, Medicaid, claims support, grievance resolution, HIPAA compliance, CMS requirements, and cross-functional collaboration.

Contact Center Operations Analyst I - WellCare Health Plans / Centene - Remote

(2022-08 - 2026-09)

• Support contact center operations serving healthcare members and providers by researching service requests, transactions, incomplete submissions, and documentation needs.
• Navigate reporting, case management, and internal resource systems to gather information, validate data, and support timely resolution of operational and customer service issues.
• Prepare and deliver performance and compliance reporting that supports quality, productivity, accuracy, and management decision-making.
• Identify trends, reporting discrepancies, system issues, and workflow improvement opportunities; present clear findings and recommendations to leadership.
• Develop SOPs and job aids that strengthen process consistency, knowledge sharing, and successful adoption of new systems and requirements.

Executive Response Specialist - WellCare Health Plans / Centene - Remote

(2020-06 - 2022-08)

• Investigated complex and sensitive member and provider complaints involving benefits, authorizations, service determinations, and escalated matters.
• Listened carefully, asked focused questions, researched root causes, documented findings, attached supporting records, and coordinated appropriate follow-up.
• Collaborated with Intake, Claims, Enrollment, Clinical, Appeals, Pharmacy, and Provider Relations teams to resolve cases within CMS timelines.
• Communicated complex healthcare information clearly and professionally while maintaining empathy, composure, HIPAA standards, and documentation accuracy.
• Coached and mentored team members on company policies, plan benefits, procedures, and complaint-handling requirements.

Senior Grievance Coordinator - WellCare Health Plans - Remote

(2020-02 - 2020-06)

• Reviewed, processed, and documented sensitive healthcare grievances requiring accurate intake, complete records, and regulatory compliance.
• Triaged incoming complaints, researched root causes, and routed cases to the appropriate departments for efficient resolution.
• Partnered with Claims, Intake, Enrollment, Billing, Member Services, Appeals, Pharmacy, and Provider Relations to resolve escalated requests.
• Conducted peer audits and quality reviews to verify documentation completeness and adherence to grievance procedures.

Care Coordinator / Grievance - WellCare Health Plans - Remote

(2017-01 - 2020-02)

• Supported Medicare and Prescription Drug Plan members and providers by phone and correspondence regarding benefits, eligibility, authorizations, complaints, and grievances.
• Researched inquiries, explained plan information in clear and easy-to-understand language, and maintained detailed CRM and case-management records.
• Coordinated with internal departments to deliver timely resolutions while meeting CMS, HIPAA, quality, and accuracy requirements.

Program / Referral Coordinator - Sunshine Health LTC (Centene Corp) - Florida

(2015-02 - 2017-01)

• Coordinated intake, referral, and authorization requests; verified eligibility and provider information; and maintained accurate service documentation.
• Prepared care-coordination correspondence and routed member, provider, and case manager requests to appropriate teams for review and resolution.

Associate of Science - Health & Human Service Management - University of Phoenix