GRINDLE A. MCCRAY
Fairburn,Georgia
Overview
30
30
years of professional experience
Work History
RN, Denial Management Coordinator
Forrest General Hospital
Hattiesburg, Mississippi
09.2018 - Current
- Focusing on correct level of care on admission, billing, coding and payer requirements and practices.
- The main objective is resolving denials.
- I often work with Utilization Review Managers, Case Managers, Social Workers and Team Leaders for Case Management, Registration, Coding and Accounts.
- Main Systems used in my current role is Epic, Interqual and (MCG) Milliman Care Guidelines.
- I follow the patient from notification of a denial to resolution.
- I review and research reason for the denial, validity in a timely manner, and offer to change the outcome that essentially, promotes legal and financial revenue for the hospital.
- I help to assure compliance per payer standards, appeal rights and grievances.
- My main objective is advocating for patients, while achieving optimum revenue for the hospital facility.
RN Utilization Review Manager
Forrest General Hospital
Hattiesburg, Mississippi
07.2017 - 09.2018
RN Case Manager
Forrest General Hospital
Hattiesburg, Mississippi
04.2011 - 07.2017
Assistant Nurse Manager
Multicare – Allenmore Hospital
Tacoma, Washington
09.2008 - 12.2010
Registered Nurse
Nightingale Nursing (Travel) Agency
Boca Raton, Florida
Registered Nurse, Behavioral Health – Dual Diagnosis Adult Unit
Brentwood Behavioral Healthcare
Flowood, Mississippi
09.2007 - 04.2008
Registered Nurse, Medical/Surgical Unit
River Oaks Hospital
Flowood, Mississippi
04.2007 - 04.2008
Registered Nurse, Medical/Surgical Unit
Southside Regional Memorial Hospital
Petersburg, Virginia
05.2006 - 02.2007
Nurse Extern/PCP, Step down Unit
VA Commonwealth University Medical Center
Richmond, Virginia
05.2005 - 05.2006
Secretary, Emergency Department
Bon Secours Health System
Newport News and Portsmouth, Virginia
07.2004 - 07.2005
Employment Coordinator, Human Resources
Bon Secours Health System
Newport News and Portsmouth, Virginia
12.2003 - 08.2004
Human Resources Assistant
Bon Secours Health System
Newport News and Portsmouth, Virginia
07.2002 - 12.2003
Administrative Assistant, PCS
St. Dominic- Jackson Memorial Hospital
Jackson, Mississippi
04.1996 - 05.2002
Unit Secretary, Orthopedics
St. Dominic- Jackson Memorial Hospital
Jackson, Mississippi
04.1996 - 07.1997
Timeline
RN, Denial Management Coordinator
Forrest General Hospital
09.2018 - Current
RN Utilization Review Manager
Forrest General Hospital
07.2017 - 09.2018
RN Case Manager
Forrest General Hospital
04.2011 - 07.2017
Assistant Nurse Manager
Multicare – Allenmore Hospital
09.2008 - 12.2010
Registered Nurse, Behavioral Health – Dual Diagnosis Adult Unit
Brentwood Behavioral Healthcare
09.2007 - 04.2008
Registered Nurse, Medical/Surgical Unit
River Oaks Hospital
04.2007 - 04.2008
Registered Nurse, Medical/Surgical Unit
Southside Regional Memorial Hospital
05.2006 - 02.2007
Nurse Extern/PCP, Step down Unit
VA Commonwealth University Medical Center
05.2005 - 05.2006
Secretary, Emergency Department
Bon Secours Health System
07.2004 - 07.2005
Employment Coordinator, Human Resources
Bon Secours Health System
12.2003 - 08.2004
Human Resources Assistant
Bon Secours Health System
07.2002 - 12.2003
Administrative Assistant, PCS
St. Dominic- Jackson Memorial Hospital
04.1996 - 05.2002
Unit Secretary, Orthopedics
St. Dominic- Jackson Memorial Hospital
04.1996 - 07.1997
Registered Nurse
Nightingale Nursing (Travel) Agency