Marquisia Simone Griffin
Cognizant
Winston Salem
6
years of professional experience
Managed claims processing and evaluation with focus on accuracy, policy compliance, and timely resolution.,Applied analytical judgment to assess complex claims and recommend effective solutions.,Partnered across teams to strengthen collaboration and support business results.,Communicated clearly with stakeholders while adapting to evolving workload and priorities.
Work History
Claim Examiner
9 Months- Reviewed medical claims for eligibility, coverage, and policy compliance using claims adjudication workflows.
- Verified documentation, coding, and authorization details to support accurate claim decisions.
- Processed complex claims in high-volume queues while maintaining consistency and turnaround requirements.
- Investigated claim discrepancies by comparing benefit plans, provider data, and supporting records.
Patient Service Advocate
2 Years 4 Months- Promotes a caring and compassionate environment.
- Schedules clinical appointments for new and returning patients
- Answers inquiries concerning clinic policies and procedures
- Communicates insurance benefits and liabilities with customers
- Collect and process upfront deposits or set-up payment arrangements
Medical Records Clerk
1 Year 9 Months- Obtains authorizations, pre-certs, documentation per request, referrals, reviews and requests medical record information as needed.
- Pre-registers all scheduled patients for admission, , and outpatient services according to department policies and procedures.
- Verifies and updates patient information per established patient registration procedures.
- Gathers documents processed during the day that remain to be filed
- Verifies eligibility on insurance in collaboration with the Insurance Clerk and the DSS workers.
Patient Service Representative
2 Years 3 Months- Performs primary source verification for both initial appointment/credentialing and re-credentialing.
- Monitors and confirms ongoing evaluation (OPPE) completed two times annually for all active provider.
- Maintains a working knowledge of the Medical Staff Bylaws, Rules and Regulations, Credentialing Manual, and Fair Hearing Plan.
- Increased efficiency and team productivity by promoting operational best practices.
- Posted payments to accounts and maintained records.
Education
High School Diploma
Medical Billing & Coding - Medical Billing & Coding
Skills
Supported appointment scheduling and calendar updates.
Protected patient privacy and confidential records.
Helped improve registration workflow.
Verified insurance coverage and eligibility details.
Assisted with insurance claim billing tasks.
Used strong organization to keep files and tasks in order.
Assisted patients with questions and service needs.
Helped improve referral workflow.
Used medical terminology accurately in daily documentation.
Processed patient payments and receipts.
Entered information accurately into electronic health records.
Completed data entry quickly and accurately.
Timeline
Claim Examiner
Cognizant
02.2026 - CurrentRead More
Patient Service Advocate
FastMed Urgent Care
07.2024 - 2025Read More
Medical Records Clerk
Trinity Glen Rehabilitation
09.2022 - 06.2024Read More
Patient Service Representative
Elevance Health
01.2021 - 04.2023Read More
North Forsyth High School
High School Diploma
Read More
Bryant & Stratton College
Medical Billing & Coding from Medical Billing & Coding
Read More