Mary A.
Mid-Level Grievance Intake & Research Analyst Team Leader
Open to offersNew to PlatformAbout
Mary L. is an experienced Team Leader and Grievance Intake & Research Analyst with a background in healthcare administration and customer service. In her current role at Helpware, she supervises a team of analysts, oversees the investigation and resolution of grievance cases, and implements process improvements to drive operational efficiency in handling sensitive casework. Previously, as a Subject Matter Expert and Grievance Intake Analyst, Mary analyzed grievance data, developed educational materials, and facilitated knowledge sharing among teams. At Optum, she coordinated appeals for Part C healthcare plans, managed case inventories, and ensured compliance with regulations. Her prior roles at Omega Healthcare, Convergys, and Aegis People Support spanned quality assurance, technical chat support, and travel services, where she demonstrated proficiency in case review, process documentation, and customer support across healthcare and travel industries.
Experience
TEAM LEADER
HELPWARE | GRIEVANCE INTAKE & RESEARCH ANALYST · 2024 — PresentSupervised a team of analysts to investigate and resolve grievance cases, ensuring accuracy and compliance while meeting deadlines for deliverables. Implemented process improvements to enhance efficiency and the quality of case resolutions, while collaborating with cross-functional teams to address escalations and maintain service level agreements (SLAs).SUBJECT MATTER EXPERT
HELPWARE | GRIEVANCE INTAKE ANALYST · 2023 — 2024Analyzed incoming grievance data to identify trends and common issues, providing insights and recommendations for process improvements. Developed presentations and quizzes to educate team members on grievance intake processes, ensuring that materials were comprehensive and accessible for a diverse audience.QUALITY REVIEW EXECUTIVE
OMEGA HEALTHCARE | CHANGE HEALTHCARE · 2017 — 2020Assisted patients in resolving concerns related to medical bills and navigating payment options. Conducted audit calls to ensure compliance with quality standards and process flows.CUSTOMER TECHNICAL CHAT SUPPORT
CONVERGYS | SPRINT e-CHAT · 2017 — 2020Provided assistance to patients with issues regarding medical bills and guidance on payment options, while also conducting audit calls to verify adherence to established quality standards.CUSTOMER SERVICE ASSOCIATE
AEGIS PEOPLE SUPPORT | EXPEDIA · 2017 — 2020Supported customers with booking flights and hotels, ensuring adherence to company policies. Facilitated schedule adjustments and cancellations, offering guidance on fees and alternative solutions. Collaborated with travel partners and team members to resolve complex issues, enhancing the overall customer experience.APPEALS COORDINATOR
OPTUM | PART C PLANSReviewed denied services in collaboration with medical professionals to facilitate approvals or denials. Provided guidance to the team on complex cases and updated processes and regulations, while managing case inventory to ensure timely resolution and compliance.
Skills & Expertise
Education
- Bachelor of Secondary Education (undergraduate)UNIVERSITY OF THE VISAYAS – MAIN CAMPUS
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