Laverne Kerridge
@lavernekerridge
Healthcare operations leader specializing in grievance and appeals, process optimization, and team development.
What I'm looking for
I am a dynamic healthcare leader with over 10 years of focused experience in grievance and appeals, team supervision, and process optimization across Medicare, Medicaid, and Commercial lines. I have a proven record of improving operational efficiency, ensuring regulatory compliance, and driving measurable performance improvements in high-volume environments.
I excel at coaching and mentoring teams, streamlining workflows, and applying data analysis to inform decision-making. My accomplishments include overseeing 1,000+ grievances annually, leading cross-functional collaboration, and implementing process improvements that enhanced accuracy and timeliness of deliverables.
Experience
Work history, roles, and key accomplishments
Supervisor, Grievance and Appeal
EmblemHealth
Jul 2013 - Mar 2025 (11 years 8 months)
Managed appeals for 1,000+ grievances annually across Medicare, Medicaid, and Commercial lines, improving timeliness and regulatory compliance while leading and developing a high-performing team.
Senior Specialist, Grievance and Appeals
EmblemHealth
May 2007 - Jul 2013 (6 years 2 months)
Managed complex appeals, complaints, and grievances, maintained audit-ready documentation, and resolved issues through detailed analysis to ensure timely, compliant case outcomes.
Senior Medical Claims Examiner
EmblemHealth
Dec 2000 - May 2007 (6 years 5 months)
Reviewed and processed complex medical claims, investigated potential fraud/abuse, mentored junior examiners, and managed appeals to ensure accurate claims adjudication and trend reporting.
Education
Degrees, certifications, and relevant coursework
Laverne hasn't added their education
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Availability
Location
Authorized to work in
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Skills
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