Denise Robinson

Manage provider data and quality assurance processes to maintain database integrity, generate reports, and coordinate corrective actions that improve data accuracy. Conduct provider outreach and support audits and initiatives to enhance data quality.

Reviewed and routed provider messages regarding admissions and discharges via care coordination platforms, verified member information, and maintained accurate administrative records including disenrollments and authorization shells. Coordinated cross-team communication to resolve issues.

Entered and verified member data in care management systems, managed administrative documentation for transitions and authorizations, and facilitated coordination between providers and the health plan to support member care.

Assisted customers with service explanations, price quotes, and order processing while escalating complex issues to appropriate departments to maintain high customer satisfaction. Managed inquiries related to billing and package tracking.

Supported callers with appointment scheduling, prescription refills, new patient registration, and clinical triage, connecting patients to appropriate medical resources and ensuring efficient inbound call handling.

Set up telehealth devices in long-term care and assisted living facilities, monitored patient sessions with therapists, and documented visit outcomes to support remote therapy delivery.

Processed daily financial transactions, opened accounts, managed deposits and withdrawals, and assisted account specialists with balancing and problem resolution to ensure accurate customer service.

Handled inbound/outbound calls, scheduled patients using various EMR systems, and provided program-specific information and customer service to support opioid-use disorder treatment access.

Scheduled, modified, and canceled transportation reservations while documenting customer concerns, performing trip authorization gatekeeping, and routing calls to appropriate parties to resolve issues.

Performed monthly wellness outreach calls, updated patient charts with clinical changes, supported clinical staff with medical records management, and assisted enrollment in Chronic Care Management programs.

Pursuing a Bachelor of Science in Health Care Administration with a concentration in Health Information Management, expected to start April 2025 and delivered remotely.

Grade: 4.0 GPA

Completed an Associate Degree in Health Science - Medical Administration program with a 4.0 GPA and recognition on the Dean's List and Honor Roll.

Completed a Certified Nursing Assistant certification program in Greenville, SC.

Graduated with a high school diploma from Woodmont High School in Greenville, SC.