Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Deseray Armstrong

Kissimmee,FL

Summary

Experienced healthcare professional with expertise in managing pharmacy claims, member services, and prior authorizations. Proven track record of delivering exceptional customer service, handling member and provider inquiries, and navigating healthcare systems. Skilled in data analysis, Medicare/Medicaid services, and compliance with healthcare regulations.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Associate Enrollment and Eligibility

UnitedHealthcare
04.2025 - Current
  • Processed enrollment in coverage that could affect claims or authorization outcomes.
  • Respond to clients inquiries related to plan enrollment, benefits, and data integrity.
  • Ensure timely processing of files in accordance with CMS and company standards.
  • Self-motivated, with a strong sense of personal responsibility.

Member Advocate

United Healthcare
10.2022 - 04.2025
  • Respond to member and provider inquiries related to medical claims, coverage, and prior authorizations.
  • Manage intake of medical referrals, prior authorization requests, and hospital admission notifications.
  • Coordinate with clinics, hospitals, and internal clinical teams to facilitate efficient care delivery.
  • Educate members on plan benefits and guide them through appeals, authorizations, and exceptions processes.
  • Document all interactions with accuracy while maintaining adherence to HIPAA and compliance standards.

Fraud Investigator

SunTrust
05.2018 - 10.2022
  • Investigated fraudulent claims and transactions, ensuring compliance with banking regulations.
  • Analyzed data to identify patterns and prevent future occurrences.

Sales Representative

UnitedHealthcare
07.2014 - 01.2018
  • Educated clients on Medicare and Medicaid plans, assisting with enrollment and plan selection.
  • Ensured compliance with state and federal regulations during sales interactions.
  • Resolved customer inquiries with a focus on satisfaction and retention.

Education

Online Course - Technology, Data Analysts

Merrit America
01.2024

Skills

  • Prior Authorization Intake
  • Enrollment Eligibility
  • Claims and Benefits Resolution
  • Medicare/Medicaid Eligibility Knowledge
  • Medical Referral & Admission Notifications
  • ICD-10, CPT Codes & Insurance Terminology
  • HIPAA & Regulatory Compliance
  • Call Center Operations & Multitasking
  • Member and Provider Communication
  • Data Entry & Documentation Accuracy

Certification

  • Certified Trainer Assistant, United Healthcare-2024
  • Member Experience Champion, Untied Healthcare-2023

Timeline

Associate Enrollment and Eligibility

UnitedHealthcare
04.2025 - Current

Member Advocate

United Healthcare
10.2022 - 04.2025

Fraud Investigator

SunTrust
05.2018 - 10.2022

Sales Representative

UnitedHealthcare
07.2014 - 01.2018

Online Course - Technology, Data Analysts

Merrit America

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Deseray Armstrong