Caryn A. Granito
Gallatin,TN
Summary
Seasoned Grievance & Appeals Lead at Elevance Health, skilled in managing and mentoring a team of 20-30 analysts to ensure compliance with federal regulations and improve resolution efficiency. Expert in communication and proficiency in Microsoft Office, consistently achieving project goals within budget while adapting quickly to change.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Grievance & Appeals Lead (Remote)
Elevance Health (Anthem Blue Cross Blue Shield)
Indianapolis, IN
06.2002 - Current
- Managed a team of 20-30 analysts, ensuring effective handling of member-submitted grievances and appeals, and mentored co-worker-related discrepancies.
- Ensured strict adherence to state and federal regulations, including Centers for Medicare & Medicaid Services (CMS) guidelines, Health Insurance Portability and Accountability Act of 1996 (HIPAA), and Affordable Care Act (ACA) requirements, to maintain compliance and avoid performance guarantee penalties.
- Analyzed trends in grievance and appeal cases to highlight areas needing improvement.
- Coordinated, interdepartmental efforts to enhance resolution efficiency, including cases submitted by fellow associates.
- Achieved project goals punctually while maintaining budget constraints.
Education
Associate of Science - Liberal Science
Sullivan County Community College
Loch Sheldrake, NY12-1997
High School Diploma -
Monticello Central School
Monticello, NY06-1994
Skills
- Outstanding written and oral communication skills
- Independently Motivated
- Proficient with Microsoft Office, including Word, Excel, Outlook, PeopleSoft, and Workday
- Adept at Addressing Sensitive Issues
- Effective Time Management
- Display the ability to learn rapidly and adapt quickly to changing situations
- Experienced Notary Public
Certification
- Notary Public, State of Tennessee (since 2017)
Timeline
Grievance & Appeals Lead (Remote)
Elevance Health (Anthem Blue Cross Blue Shield)
06.2002 - Current
- Notary Public, State of Tennessee (since 2017)
Associate of Science - Liberal Science
Sullivan County Community College
High School Diploma -
Monticello Central School
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