Summary

Overview

Work History

Education

Skills

Timeline

Courtney Derrickson

La Vergne

Summary

Appeals and operations specialist with 8+ years of experience supporting healthcare, insurance, and government programs. Strong background in case review, documentation analysis, compliance support, and workflow optimization. Proven ability to manage complex appeals, meet regulatory deadlines, and improve resolution timelines in high-volume environments. Recognized for accuracy, adaptability, and cross-functional collaboration.

Seasoned Appeals Specialist with background in legal document preparation, claims resolution, and client advocacy. Possess strong skills in negotiation, conflict resolution, and regulatory compliance. Impact made by improving efficiency of appeals processes and fostering positive relationships with clients. Committed to maintaining up-to-date knowledge on industry standards and procedures for effective leadership.

Overview

years of professional experience

2002

years of post-secondary education

Work History

Appeals Specialist / Customer Service Rep

Acentra Health

08.2022 - Current

Reviewed and processed healthcare appeals in accordance with regulatory and organizational guidelines
Analyzed incoming documentation, identified missing information, and obtained required materials to support case determinations
Streamlined appeals workflows, contributing to faster turnaround times and improved case resolution metrics
Collaborated with internal teams to ensure timely and accurate case progression
Maintained accuracy and professionalism while managing complex, time-sensitive cases in high-volume environment

CSR II / Lead

Tennessee Department Of Revenue

03.2021 - 03.2022

Served as lead support for complex account inquiries, providing guidance and resolution for escalated issues
Ensured compliance with state policies while maintaining accuracy in customer account documentation
Acted as subject matter resource for peers, supporting training and daily operations
Balanced high-volume workload while maintaining quality, efficiency, and attention to detail
Strengthened communication between departments to support timely issue resolution

Senior CSR / Trainer

DXC Technology

12.2019 - 02.2021

Trained and onboarded 15+ new hires, ensuring readiness for production environments
Developed and delivered training materials to support operational consistency and quality standards
Implemented feedback and quality tracking to support continuous improvement initiatives
Maintained strong performance metrics while supporting team development and knowledge transfer

Direct Sales / Conservation Specialist

Aetna Health

02.2018 - 12.2019

Supported Medicare Advantage members by providing detailed plan education and guidance
Retained clients through needs assessment and tailored solutions
Collaborated with internal teams to support enrollment accuracy and member satisfaction
Managed consistent daily volume of inbound communications with attention to compliance

Insurance Producer

Acceptance Insurance

04.2014 - 12.2017

Generated new business and maintained client relationships in regulated insurance environment
Conducted needs assessments to identify coverage gaps and recommend appropriate solutions
Met or exceeded sales and service performance targets
Managed high-volume client communications with accuracy and professionalism