Paris P.

Key Skills

Software

Don't disclose

Top Subject Matter

Healthcare grievance & appeals (regulated medical/insurance review)

Customer service case resolution (benefits information review)

Legal Services & Contract Review

Top Data Types

Document

Text

Top Task Types

Classification

Freelancer Overview

Elevance Health – Grievance & Appeal Analyst (quality review and evidence-based evaluation). Brings 15+ years of professional experience across legal operations, contract review, compliance, and structured analysis. Core strengths include Don't disclose, Internal, and Proprietary Tooling. Education includes Coursework, College for America and Coursework, Clayton State University. AI-training focus includes data types such as Document and labeling workflows including Evaluation, Rating, and Classification.

Labeling Experience

Elevance Health – Grievance & Appeal Analyst (quality review and evidence-based evaluation)

Don't discloseDocument

Reviewed and evaluated complex grievance and appeal case materials by applying established policies, procedures, and regulatory guidelines. Produced detailed written determinations and case summaries while identifying discrepancies, missing information, and documentation gaps to ensure accuracy and quality. Performed structured decision-making quality review to support consistent, evidence-based outcomes. • Evaluated case documentation for completeness and alignment with guidelines. • Verified evidence via extensive research to support determinations. • Generated rationale and written explanations for decisions. • Coached/trained new hires on quality standards and review procedures.

2013 - 2025

Keystone Mercy Health Plan – Customer Service Representative (information evaluation and resolution)

DocumentClassification

Researched member inquiries and analyzed account information to provide accurate resolutions. Evaluated benefits information and communicated findings through written and verbal correspondence while maintaining detailed records. Performed information review and quality assurance on responses for accuracy and completeness. • Researched and verified information from internal systems. • Documented outcomes and maintained detailed records. • Assessed benefits details to resolve member inquiries. • Communicated findings clearly in written and verbal formats.

2011 - 2012

Education

Work History