Carmen R. Ray has over 20 years of experience in healthcare project coordination, medical research, and claims analysis. She has worked in roles managing healthcare benefits administration, process development and documentation, and executive support. Her experience includes positions at Mylan, Office Team, Corvel Corporation, UPMC Health Plan, and Cigna analyzing medical claims, conducting utilization reviews, and training staff. She holds an MBA in Business Administration from Point Park University and certificates in health information technology and as a nursing assistant.

1. Carmen R. Ray
1037 Greenfield Drive  Canonsburg, PA 15317
412-759-1082  crray3152@comcast.net
Project Coordinator
Comprehensive experience in medical and healthcare project coordination, research and analysis for organizations in
the public and private sectors seeking increased efficiency, service levels and performance. Skilled team leader and
staff trainer and developer. Proficient in reviewing, vetting and authorizing medical claims according to benefits and
organization and government compliance. Healthcare data analysis and auditing expert.
CORE COMPETENCIES
Medical Research Coordination  Healthcare Benefits Administration  Project Management
Process and Procedure Development and Analysis  Program Management
Solutions Advice  Claims Analysis  New Hire Onboarding  Process Documentations
Executive Support  Opportunity Identification  Team Leadership and Training
EXPERIENCES AND ACHIEVEMENTS
MYLAN, Canonsburg, PA 2013 – Current
Wing Service Assistant
Essential support staff tasked with providing clerical assistance including but not limited to processing and
distributing both incoming and outgoing mail, ordering workplace supplies and providing backup support and
assistance to the receptionist for breaks as needed.
 Assisted executive staff with catering set-up and breakdown.
 Managed event ticket allocation and distribution and conducted workplace studies.
OFFICE TEAM, Pittsburgh, PA 2013 – 2014
Administrative Assistant
Managed a variety of administrative and clerical functions in a high-volume office environment including but not
limited to fielding incoming telephone calls and addressing them accordingly. Coordinated meetings, interviews,
events and other appointments.
 Oversaw new hire processing by preparing new hire packages for new employee on-boarding. Enrolled new
employees in HRIS system and provided information assistance to questions regarding employee benefits and
annual enrollment.
 Developed recruitment list applicable to each job posting.
CORVEL CORPORATION, Pittsburgh, PA 2011 – 2013
Senior Medical Review Analyst
Analyzed and reviewed claims to ensure proper reimbursement for automobile and workers’ compensation claims.
Recovered and retrieved funds from providers due to overpayment and adjusted provider claims for overpayment
and underpayment. Audited hospital and other medical bills to adhere to specific state guidelines.
 Trained and assisted claims staff on quality health care cost containment and utilization reviews.
 Performed effective research on larger projects and major reconciliations.
UPMC HEALTH PLAN, Pittsburgh, PA 2006 – 2011
Clinical Review Specialist
Conducted and performed research for Medical Directors. Created and managed authorization for pre-determination
medical necessity cases. Collaborated with internal teams in order to comply with service delivery standards.
 Documented the authorization process and procedures to each healthcare provider.

2. Carmen R. Ray Resume, Page 2
Experiences and Achievements continued…
CIGNA, Pittsburgh, PA 2000 – 2005
Utilization Management Care Associate
Oversaw patient/hospital claim and benefits complications. Served as expert in interpreting various benefit plans
based upon federal and state mandates and liaison between each hospital and the patient, identifying and resolving all
escalated client issues. Managed day-to-day account activities.
t Verified patient eligibility and derived appropriate benefit determinations in clinical scenarios.
t Mentored and trained new and temporary employees.
EDUCATION
Master of Business Administration, Business Administration, Point Park University, Pittsburgh, PA
Bachelor of Science, Business Administration, Point Park University, Pittsburgh, PA
Associates Degree, Business, Bradford School of Business, Pittsburgh, PA
Health Information Technology Certificate, Community College of Allegheny County, Pittsburgh, PA
Certificate-Nursing Assistant, Western School of Health, Pittsburgh, PA