DENNISHA GRAY
Pikesville
Summary
Experienced Healthcare Operations and Patient Advocacy Professional with 5+ years in complex care coordination, insurance navigation, and specialty patient services. Resolved claims issues, streamlined authorization processes, and improved patient experiences in high-volume clinical settings. Collaborated with providers, payers, and internal teams to facilitate timely care delivery and ensure compliance with healthcare regulations.
Overview
8
8
years of professional experience
Work History
Independent Member Advocate
OneDigital (Benemax)
Medfield
06.2024 - Current
- Serve as liaison between patients, providers, pharmacies, and insurers to resolve complex healthcare issues.
- Resolved __% of claims issues within __ days, improving turnaround time.
- Verify eligibility and benefits supporting accurate billing for __+ cases weekly.
- Conduct research to resolve billing disputes impacting $__ in claims.
- Support __+ members navigating specialty care services monthly.
Patient Care Coordinator
CCRM
Newton
08.2023 - 05.2024
- Coordinated care for __+ patients per week across treatment cycles.
- Improved patient compliance by __% through education and follow-up.
- Managed __+ prior authorizations monthly with __% approval rate.
- Ensured HIPAA compliance across __+ patient records.
- Collaborated with clinical teams to reduce scheduling delays by __%.
Financial Coordinator
Boston IVF
Brookline
10.2021 - 08.2023
- Processed __+ insurance authorizations monthly.
- Reduced treatment delays by __% through proactive authorization management.
- Educated __+ patients monthly on financial responsibilities.
- Resolved billing discrepancies totaling $__ annually.
- Maintained __% accuracy in EMR documentation.
Processor III
Blue Cross Blue Shield MA
Quincy
03.2021 - 09.2021
- Processed __+ provider records weekly with __% accuracy.
- Maintained compliance with credentialing standards.
- Utilized systems including Salesforce and NASCO.
Member Service Representative
Blue Cross Blue Shield MA
Quincy
01.2018 - 03.2021
- Handled __+ member inquiries daily.
- Resolved __% of cases on first contact.
- Improved customer satisfaction scores to __%.
- Coordinated with providers to resolve authorization issues.
Education
Bachelor of Science - Food Service Management
Johnson & Wales University
Associate of Science - Culinary Arts
Johnson & Wales University
Skills
- Patient Advocacy & Care Coordination
- Insurance Verification & Prior Authorization
- Claims Resolution & Billing Support
- Revenue Cycle Support
- EMR Systems & Documentation
- HIPAA Compliance
- Salesforce
- NASCO
- Customer Relationship Management
- Healthcare Enrollment
- PowerPoint
- Google Workspace
- Process Improvement
- Cross-functional Communication
Timeline
Independent Member Advocate
OneDigital (Benemax)
06.2024 - Current
Patient Care Coordinator
CCRM
08.2023 - 05.2024
Financial Coordinator
Boston IVF
10.2021 - 08.2023
Processor III
Blue Cross Blue Shield MA
03.2021 - 09.2021
Member Service Representative
Blue Cross Blue Shield MA
01.2018 - 03.2021
Bachelor of Science - Food Service Management
Johnson & Wales University
Associate of Science - Culinary Arts
Johnson & Wales University