Lawrence J.

About Lawrence J.

I’m an Implementation Analyst / Implementation Consultant specializing in API-driven SaaS…

Experience

1. Appeals Analyst

   AmeriHealth Caritas

   Apr 2023 — Present

   Responsible for managing the appeal and grievances process for Medicare and Medicaid Long Term Services and Support covered individuals by performing research and investigative analysis and carrying out a compliant and ethical appeal process.Provide Quality of Care services by performing analysis of documentation in Epic and task facilitation while maintaining federal and state compliance standards and regulations including HIPAA, PHI, and PII.Achieved a 96% customer service satisfaction rating in adherence to SLA by leveraging effective communication techniques and providing insight of service processes and procedures with an intent to de-escalate situations and address customer concerns.Display continuous improvement by reducing appeal error rate by 12% month over month utilizing streamlined document management and workflows in Microsoft SharePoint.

Education

• Florida Agricultural and Mechanical University

  Master of Business Administration (M.B.A.), Human Resources / Administration

  2015 — 2017

• Florida Agricultural and Mechanical University

  Bachelor’s Degree, Health/Health Care Administration/Management

  2011 — 2015