Dayasha McCory
Blue Cross Blue Shield
Suffolk,VA
1
Certification
6
years of professional experience
Experienced healthcare administrator with six years in health insurance and eligibility management. Expertise in reviewing documentation, researching coverage, and resolving compliance issues. Communicates effectively with members and providers while ensuring confidentiality and quality assurance. Utilizes Salesforce and Microsoft Office to optimize workflows and enhance productivity in fast-paced environments.
Work History
Overseas Benefit Specialists
11 Months- Review provider and member documentation for completeness, accuracy, and eligibility, resolving discrepancies to support timely case processing.
- Reviewed provider and member documentation for completeness, accuracy, and eligibility, resolving discrepancies to enhance timely case processing.
- Collaborate with cross-functional departments to facilitate timely case resolution and maintain accurate documentation throughout the case lifecycle.
- Communicated with providers, members, and internal teams regarding documentation requirements, case updates, and benefit information to ensure clarity and compliance.
- Collaborated with cross-functional departments to expedite case resolution and uphold accurate documentation throughout case lifecycle.
- Prioritize multiple deadlines while maintaining exceptional attention to detail and quality standards.
- Collaborated with cross-functional teams to streamline operational processes and enhance service delivery.
- Prioritize high-volume workloads and complete deadlines while maintaining quality, accuracy, confidentiality, and established service expectations
Eligibility Specialist
3 Years 8 Months- Reviewed documentation and determined eligibility using established state and federal guidelines.
- Reviewed documentation and determined eligibility based on state and federal guidelines, ensuring compliance and accuracy.
- Analyzed application and case information to identify discrepancies, missing documentation, and issues requiring additional review or corrective action
- Maintained accurate electronic case records and documented case activity, facilitating effective monitoring of application status throughout review process.
- Maintained accurate electronic case records, documented case activity, and monitored application status throughout the review process.
- Communicated complex policy requirements clearly to applicants while providing exceptional customer service.
- Coordinated with internal team members to resolve documentation issues and ensure timely case completion.
Credentialing Specialist
1 Year 10 Months- Reviewed and processed provider credentialing applications for completeness, accuracy, and regulatory compliance.
- Verified professional licenses and certifications to ensure compliance with credentialing standards, enhancing accuracy of provider records.
- Researched payer and licensing requirements while resolving documentation discrepancies to facilitate timely application processing.
- Maintained organized electronic credentialing files using Salesforce, CAQH, EPDB, and NPDB.
- Collaborated with internal departments and external stakeholders to expedite provider file processing through the credentialing workflow.
- Supported healthcare administrative operations through accurate recordkeeping, documentation management, and compliance monitoring.
Education
Associate of Applied Science - Paralegal Studies
- Dean's List
Certified Supervisor - Management
Skills
Medical claim support
Claims processing Support
Case processing
High-volume processing
Discrepancy Resolution
High-volume case processing
Provider Documentation
Provider Records
Electronic Health Records
Healthcare CRM
Regulatory Compliance
Operational Efficiency
Process Management
Salesforce
Microsoft Office Suite
Claims support
Certification
Certified Supervisor — Institute of Certified Professional Managers, February 2026
Timeline
Overseas Benefit Specialists
Blue Cross Blue Shield
10.2025 - CurrentRead More
Eligibility Specialist
Maximus
02.2022 - 10.2025Read More
Credentialing Specialist
Sutherland
04.2020 - 02.2022Read More
American National University
Associate of Applied Science from Paralegal Studies
Read More
Institute of Certified Professional Managers
Certified Supervisor from Management
Read More