Tracie Brinson

Managed Medicare grievance cases from intake through resolution, ensuring compliance with CMS guidelines and internal quality standards.

Conducted detailed investigations by reviewing claims, provider notes, call logs, and system data to determine root causes and appropriate resolutions.

Prepared clear, accurate, and timely written responses for members, providers, and regulatory bodies.

Collaborated with clinical teams, claims departments, and quality improvement units to resolve complex issues.

Monitored case timelines to ensure all grievances were completed within required regulatory timeframes.

Identified trends in member complaints and contributed to process improvement initiatives.

Maintained strict confidentiality and adhered to HIPAA and CMS regulations.

• Delivered high‑quality support to members by answering inquiries, resolving issues, and providing accurate benefit and claims information.
• Handled high‑volume inbound calls while maintaining strong service metrics, including call quality, accuracy, and customer satisfaction.
• Assisted members with billing questions, coverage explanations, and provider network navigation.
• Documented all interactions thoroughly in CRM systems to support continuity of care and compliance.
• De‑escalated challenging situations with professionalism and empathy, ensuring positive outcomes.
• Collaborated with internal teams to resolve complex or escalated member concerns.
• REASON FOR LEAVING: School

• Assisted customers with booking Delta Vacations packages, including flights, hotels, car rentals, and excursions.
• Provided accurate information on pricing, availability, travel policies, and package inclusions.
• Processed itinerary changes, cancellations, reissues, and special requests while adhering to company and airline guidelines.
• Resolved customer concerns related to travel disruptions, schedule changes, and service issues with professionalism and empathy.
• Coordinated with airlines, hotel partners, and internal departments to resolve booking discrepancies and ensure seamless travel experiences.
• Utilized reservation systems and GDS tools (such as Worldspan or similar platforms) to manage bookings and update customer records.
• Delivered high‑quality service in a fast‑paced call center environment while meeting performance metrics such as call quality, handle time, and customer satisfaction.
• Assisted customers with travel documentation requirements, payment processing, and promotional offers.
• De‑escalated challenging situations and provided solutions that aligned with Delta Vacations policies and customer needs.
• Maintained detailed and accurate documentation of all customer interactions and booking updates.
• Stayed current on travel advisories, destination information, and Delta Vacations product offerings to provide informed guidance.
• REASON FOR LEAVING: Better Opportunity