April Gray
Spring Hill,FL
Summary
Dedicated individual with exceptional time management capabilities and a knack for prioritizing tasks, eager to contribute my organizational skills to a supportive team and learn new responsibilities in a new role
Overview
1
1
Certification
29
29
years of professional experience
Work History
Clinic Assistant
Pasco County Schools
Land O' Lakes, FL
08.2025 - Current
- Provided administrative support to healthcare staff, ensuring efficient clinic operations.
- Assisted in patient scheduling and intake processes, improving appointment flow.
- Maintained accurate medical records and documentation, promoting compliance with regulatory standards.
- Coordinated communication between families and healthcare providers, enhancing patient care experience.
Senior Resolving Analyst
United Healthcare
11.2019 - Current
- Research and resolve written appeals submitted by members and providers
- Ensure appeal has been categorized correctly
- Obtain additional documentation required for case review
- Review case to determine if review by clinician is required
- Render decision for administrative appeals using sound, fact-based decision making
- Complete necessary documentation of final appeals determination using appropriate templates
- Send written appeal resolution to members or providers and internal/external parties within the required timeframes
- Ability to manage inventory of appeals in a fast-paced environment with deadlines, and competing priorities
- Must have exceptional multi-tasking skills with the ability to prioritize tasks.
- Manage assigned inventory to ensure timely and accurate resolution of cases.
- Achieved over 100% of quality audits, corporate audits, and quality
Claims Associate
United Healthcare
11.2003 - 11.2019
- Processing medical claims within the Internal Resolution Unit
- Responsible for making decisions to accept, deny or approve claims as per established guidelines
- Accountable for complying with set departmental standards, corporate policies and governmental regulations to solve claim related issues
- Process claims for provider contracts, Pega, medicare and other insurance companies
- Achieved over 100% of production goals 11/12 months
- Adjudication claims accurately on basis of insurance, benefits included and provider contracts
- Attained 100% quality 10/12 months
- Selected by leadership, based on superior performance, to process high profile speciality groups
- Selected by leadership to be a Beta tester for the new system: Wand Work Space
- Engaged to train employees on speciality group processing
- Endorsed for telecommuter status based on high performance and excellent work ethics
- Basic to intermediate skills in Excel, Microsoft outlook, Microsoft word and National Data Base
Assistant Manager Tax Service
Amscot
Port Richey, FL
10.2010 - 01.2013
- Responsible for greeting customers, answering phones, reviewing and preparing both consolidated company federal, individual tax returns, and multi state returns
- Accountable for scheduling and supervising tax returns and staff
- Researched, planned and trained staff on various tax issues and new tax laws
Front Office Staff
NPCMC
New Port Richey, FL
03.1997 - 11.2003
- Receptionist/Office Manager/Medical Assistant/Billing Specialist
- Responsibilities:
- Answering phones, handling patients, scheduling appointments, filing
- Proficient in Microsoft Office, Medical Data Programs and Medical Manager
- Successfully managed multiple projects concurrently ensuring timely completion and high quality of tasks
Patient Care Tech/Unit Secretary
Morton Plant Mease
Dunedin, FL
03.1997 - 11.1998
- Responsibilities include: checking vital signs and assisting patients for procedure and helping them to recover from surgery
- Accurately maintained patient vitals prior and after heart surgery: inputting Physicians orders and scheduling procedures
Education
Diploma -
James H Groves
Stanton, DE05-1985
Certificate - Certified Nursing Assistant/Patient Care Tech/ HIPAA Certification
Morton Plant Mease Hospital
Dunedin, FLCertificate - HIPAA Certification
United Healthcare
Oldsmar, FLCollege - Medical Terminology
PHSC
Spring Hill, FLSkills
- Word
- Excel
- Power Point
- Vital signs monitoring
- HIPAA regulations
- Critical thinking
- Team collaboration
- Emergency response preparedness
Certification
Healthcare Provider CPR/AED: Adult, Child&Infant + First Aid
Identifying and Reporting Child Abuse and Neglect
Timeline
Clinic Assistant
Pasco County Schools
08.2025 - Current
Senior Resolving Analyst
United Healthcare
11.2019 - Current
Assistant Manager Tax Service
Amscot
10.2010 - 01.2013
Claims Associate
United Healthcare
11.2003 - 11.2019
Front Office Staff
NPCMC
03.1997 - 11.2003
Patient Care Tech/Unit Secretary
Morton Plant Mease
03.1997 - 11.1998
College - Medical Terminology
PHSC
Certificate - HIPAA Certification
United Healthcare
Certificate - Certified Nursing Assistant/Patient Care Tech/ HIPAA Certification
Morton Plant Mease Hospital
Diploma -
James H Groves