Christina Mitchell

I’m a Healthcare Operations professional with 14 years of remote healthcare experience specializing in Medicare Advantage, Medicaid, Appeals & Grievances, and CMS-regulated operations. I bring an MBA background and a steady focus on accurate, evidence-based decisions that support member outcomes.

In my current role as a Grievance & Appeals Coordinator, I lead investigations of complex Medicare Advantage and Medicaid appeals by analyzing medical records, claims, authorizations, and benefit determinations. I interpret CMS regulations, medical policies, and health plan benefits to ensure compliant and timely decisions while managing a high-volume caseload in a fully remote environment.

I collaborate closely with Medical Directors, Provider Affairs, Compliance, Clinical Operations, and cross-functional teams to resolve complex healthcare issues. I serve as a trusted liaison between members, providers, and internal stakeholders—translating policy requirements into practical next steps and clear communication.

Earlier in my career at Blue Cross Blue Shield of Michigan and Verizon Wireless, I strengthened my analytical problem-solving and operational excellence through complex member and provider issue resolution, eligibility and coverage work, and escalated billing/service troubleshooting. Across every role, I’ve built trusted relationships and consistently improved service delivery through thoughtful, process-driven execution.