DAVA GRIFFIN
Raleigh,NC
Summary
Ambitious, career-focused job seeker, anxious to obtain an entry-level position to help launch career while achieving company goals.
Overview
6
6
years of professional experience
Work History
Claims Processor
United Healthcare Group
03.2024 - Current
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Managed workload and priorities to meet claims processing meet deadlines.
Sr Care Navigator
Ascension
11.2024 - Current
- Consistently maintained confidentiality while handling sensitive patient information in accordance with HIPAA guidelines.
- Reduced hospital readmissions for patients through proactive follow-up and continuous communication.
- Assisted patients in scheduling doctor and healthcare appointments.
- Answered incoming calls, scheduled appointments and filed medical records.
Quality Assurance Specialist
Unit Dose Solutions
11.2023 - 03.2024
- Monitored QA procedures for adherence by employees, notifying personnel of non-compliance issues
- Analyzed quality assurance data to identify trends and develop and implement corrective action plans
- Consulted with management and personnel to educate on QA standards
- Used quality monitoring data management systems to compile and track performance at team and individual levels
- Secured positive customer experiences while executing effective quality assurance practices.
Medical Records Specialist
Duke Regional Hospital
12.2022 - 11.2023
- Improved patient care by maintaining accurate and up-to-date medical records for easy access by healthcare practitioners.
- Ensured smooth operations within the department by managing a team of medical records technicians and providing ongoing training and support.
- Assisted healthcare providers with timely access to patient information, facilitating optimal treatment decisions.
- Maintained compliance with HIPAA regulations through thorough staff training and continuous monitoring of security protocols surrounding patient data management.
- Provided outstanding customer service to patients requesting copies of their medical records or seeking assistance with related inquiries.
- Established strong relationships with insurance companies and other external partners involved in processing claims or accessing patient information.
Medical Billing Specialist
Wake Med
04.2021 - 02.2022
- Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections
- Answered customer invoice questions and resolved issues discovered during invoicing and collection process
- Investigated and resolved issues to maintain billing accuracy
- Managed account receivables to maintain payments within net terms
- Recorded amounts due for items purchased or services rendered by preparing statements, bills or invoices
- Contacted insurance providers to verify insurance information and obtain billing authorization
- Processed and sent invoices, adjustments and credit memos to customers.
Medical Collections Representative
Conduent
08.2020 - 04.2021
- Reasoned with customers and attempted to negotiate full balance payments
- Advised debtors on payment options and set up payment plans
- Handled irate customers smoothly to achieve performance targets
- Entered customers' financial status information into system
- Used effective questioning techniques to clarify why debtors were delinquent.
Call Center Representative
Amazon
08.2019 - 08.2020
- Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer
- Answered, screened and processed high volume of calls daily with call management system and web-based communications
- Maintained strong call control and quickly worked through scripts to address problems
- Updated customer accounts, addresses and contact information within call management databases
- Asked probing questions to determine service needs and accurately input information into electronic systems
- Consulted with customers to resolve service and billing issues.
Education
High School Diploma -
Millbrook High School
Raleigh, NC06.2019
Pharmacy Technician -
Stepful
06.2025
Skills
- Team Management
- Planning & Organizing
- Microsoft Office
- Medical Terminology
- Reliable & Trustworthy
- Data Management
- Active Listening
- Customer Service
- Good Work Ethic
- Friendly, Positive Attitude
- Computer Proficiency
- Claim Investigation
- Appointment Scheduling
- Medicaid Knowledge
- Understanding of Medical Terms
- HIPAA Compliance
- OSHA Compliance
- ICD-10 Coding
- Insurance Verification
- Follow-Up Skills
- Patient Registration
- Scheduling Diagnostic Procedures
- Registration and Admissions
- Patient Check-In
- Patient Scheduling
- Appointment Coordination
- Electronic Health Records
- Medical Office Procedures
Timeline
Sr Care Navigator
Ascension
11.2024 - Current
Claims Processor
United Healthcare Group
03.2024 - Current
Quality Assurance Specialist
Unit Dose Solutions
11.2023 - 03.2024
Medical Records Specialist
Duke Regional Hospital
12.2022 - 11.2023
Medical Billing Specialist
Wake Med
04.2021 - 02.2022
Medical Collections Representative
Conduent
08.2020 - 04.2021
Call Center Representative
Amazon
08.2019 - 08.2020
High School Diploma -
Millbrook High School
Pharmacy Technician -
Stepful