Christina Springer
Pensacola,FL
Summary
Healthcare professional with 15+ years of experience supporting members and providers through claims processing, utilization review, and investigative workflows. Known for optimizing operations, mentoring teams, and ensuring regulatory compliance. Recognized for cross-functional collaboration, process improvement, and attention to quality and financial discipline.
Overview
13
13
years of professional experience
Work History
Claims Exam Processor
Oscar Health
07.2023 - Current
- Conduct Special Investigations Unit (SIU) intake and triage.
- Identify risks and resolve escalated issues/errors through investigative review, ensuring compliance and insight generation.
- Coordinate projects and workflows to meet service level targets and key milestones.
- Serve as Subject Matter Expert (SME) for PFWA and CAREX workflows, mentoring new and existing team members.
- Help develop and deliver training materials for new processes and contribute to knowledge-sharing meetings.
- Partner with leadership to strategize and implement improvements that reduce costs or enhance outcomes.
- Collaborate with peers across departments to align action plans with continuous improvement goals.
- Provide recommendations to promote financial discipline, quality performance, and operational excellence.
- Support process improvement initiatives and contribute to a culture shift toward performance and efficiency.
- Ensure all duties comply with internal policies and external regulations.
Clinical Review Team
Oscar Health
12.2022 - 06.2023
- Processed authorization requests to support clinical reviews and appeals.
- Ensured accurate documentation of patient/provider details, clinical records, and relevant codes for compliance and timely approvals.
Utilization Review Assistant II
Change Healthcare
03.2022 - 12.2022
- Reviewed claims with authorization violations or requiring medical review based on plan edits or business rules.
Utilization Review Assistant I
Change Healthcare
11.2018 - 03.2022
- Entered clinical authorization requests and ensured completeness for efficient review and appeals processing.
Medical Scribe
Dr. Mark Isenberg, DPM
08.2016 - 11.2018
- Transcribed medical notes into Allscripts EHR.
- Ensured accurate coding and billing.
Insurance & Billing / Front Desk
Mills Eye + Facial Surgery
12.2012 - 05.2013
- Obtained insurance authorizations, collected copays and coinsurance for surgeries, and managed pre-surgical billing.
Education
Associate of Arts - Health Sciences / Medical Assisting
Virginia College
Pensacola, FLSkills
- Clinical Skills: Injections, Venipuncture, EKGs, CPR Certified
- EHR Systems: Allscripts, Nextech, FACETS, MISys
- Software: Microsoft Word, Excel, PowerPoint, Google Docs Editors
- Process Experience: Workflow design, data-driven improvement, SIU case handling, training & facilitation
- Teamwork and collaboration
- Attention to detail
- Data entry experience
- Multitasking and organizing
Externship
- Dr. Vicky Griffin, DO, PA, OBGYN — 180 hours
- Assisted with pap smears, colposcopies, and LEEP procedures.
- Completed lab requisitions and clinical documentation.
Qualifications
- 15+ years in healthcare operations, claims, utilization review, and provider/member services
- 1+ years experience in Special Investigations Unit (SIU) intake and triage
- Experienced in ACA marketplace operations and regulatory compliance
- Strong background in data-driven process improvement and workflow redesign
- Skilled at presenting findings and recommendations to cross-functional leadership
- Coordinated training and implementation of updated processes within matrixed teams
- Familiar with Lean and Continuous Process Improvement methodologies
- Experienced with EHR systems (FACETS, Allscripts, Nextech, MISys) and Microsoft Office Suite
Timeline
Claims Exam Processor
Oscar Health
07.2023 - Current
Clinical Review Team
Oscar Health
12.2022 - 06.2023
Utilization Review Assistant II
Change Healthcare
03.2022 - 12.2022
Utilization Review Assistant I
Change Healthcare
11.2018 - 03.2022
Medical Scribe
Dr. Mark Isenberg, DPM
08.2016 - 11.2018
Insurance & Billing / Front Desk
Mills Eye + Facial Surgery
12.2012 - 05.2013
Associate of Arts - Health Sciences / Medical Assisting
Virginia College
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