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livy morganLM
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livy morgan

@livymorgan

Detail-oriented Insurance Appeals Coordinator with strong customer service skills.

United States
Message

What I'm looking for

I seek a role that values compliance and customer satisfaction, offering growth opportunities.

As an experienced Insurance Appeals Coordinator, I have developed a robust skill set in managing and resolving member grievances and appeals, ensuring compliance with CMS regulations. My role at AmeriHealth Caritas has honed my ability to draft comprehensive written responses and adjust insurance claims using various systems, including MCS and CICS. I pride myself on my exceptional communication and research skills, which have been instrumental in delivering high-quality documentation in fast-paced environments.

Prior to my current position, I served as a Customer Service Trainer at LuckyVitamin, where I trained new representatives on best practices and operational tools. My proactive approach to problem-solving and commitment to process improvements contributed to exceeding sales goals and enhancing team efficiency. I am passionate about leveraging my experience in case management and customer service to make a meaningful impact in the healthcare industry.

Experience

Work history, roles, and key accomplishments

AC
Current

Grievance Coordinator, Insurance Appeals

AmeriHealth Caritas Family of Companies

Nov 2019 - Present (5 years 10 months)

Managed and resolved member grievances and appeals via phone and written correspondence, adhering to CMS regulations. Researched and analyzed inquiries using internal databases, Medicare guidelines, and organizational procedures, while drafting accurate, timely, and comprehensive written responses to ensure clarity and regulatory compliance.

Education

Degrees, certifications, and relevant coursework

CU

Capella University

Bachelor of Science, Psychology

Currently pursuing a Bachelor of Science in Psychology. Expected to graduate in 2024.

BS

Bishop McDevitt High School

High School Diploma, General Studies

Completed high school education and received a High School Diploma.

Tech stack

Software and tools used professionally

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livy morgan - Grievance Coordinator, Insurance Appeals - AmeriHealth Caritas Family of Companies | Himalayas