Grievances and Appeals Analyst with expertise in documentation management and data analysis. Implemented innovative processes that enhanced departmental efficiency and led to successful resolutions in complex appeal cases.
Overview
10
10
years of professional experience
Work History
Grievances and Appeals Analyst
Elevance (Anthem)
Sacramento (Remote), California
03.2023 - Current
Maintained detailed documentation of appeal cases to support compliance and audit requirements.
Collaborated with cross-functional teams to address complex appeals and optimize outcomes.
Assisted in developing new processes designed to improve efficiency within the Appeals department.
Effectively communicated abstract information from patient medical records in writing.
Exhibited strong written communication skills through clear and concise expression.
Crisis Counselor
Elevance (Anthem)
Sacramento (Remote), California
06.2022 - 03.2023
Provided crisis intervention services to individuals experiencing acute emotional distress.
Conducted thorough client assessments to identify needs and develop personalized care plans.
Developed and implemented risk management strategies to enhance client safety during interventions.
Responded promptly to emergency situations by providing crisis intervention services.
Crisis Counselor
United Healthcare
Pasadena (Remote), California
03.2021 - 03.2022
Delivered emotional support to community via remote crisis hotline through chat and phone counseling.
Assisted in emergency responses to de-escalate tensions and avert potential violence.
Conducted thorough client assessments to identify needs and develop personalized care plans.
Developed safety plans to minimize crisis risk and intervene with specific procedures.
Academic Assistant
Argosy University
Los Angeles, California
08.2015 - 01.2018
Streamlined daily operations for graduate department chair, enhancing inbox management and interdepartmental coordination.
Managed inventory of books and materials for faculty, ensuring organization and availability.
Prepared timely reports, emails, and filed documents for efficient correspondence.
Coordinated department chair's calendars, meetings, and special events to optimize scheduling.
Bilingual (Spanish) Behavioral Care Clinical Care Manager at ELEVANCE/Anthem HealthcareBilingual (Spanish) Behavioral Care Clinical Care Manager at ELEVANCE/Anthem Healthcare