Candice Baynard
DOVER
Summary
Accomplished Sr Claim Data Specialist with expertise in data analysis, process optimization, and operational reporting. Proven ability to lead initiatives that enhance data analytics capabilities and streamline claims operations. Proficient in developing advanced reporting solutions and driving automation while ensuring regulatory compliance and risk mitigation. Recognized for delivering actionable insights that improve service delivery and operational efficiency.
Overview
27
27
years of professional experience
Work History
Senior Claim Data Specialist
Aetna, a CVS Health
Work from home
05.2025 - Current
- Analyzed data trends to support decision-making processes in healthcare initiatives.
- Developed and maintained reports to track performance metrics and operational efficiency.
- Collaborated with cross-functional teams to ensure data integrity and accuracy across systems.
- Assisted in the implementation of new data management tools to streamline workflows.
- Maintained open lines of communication with team members, fostering a collaborative environment that facilitated mutual learning and professional growth.
- Enhanced data accuracy by implementing efficient data validation processes and automating manual tasks.
Senior Claims Benefit Specialist
Aetna, a CVS Health
Work from home
09.1998 - 05.2025
- Ensured timely claim processing by reviewing and completing various claims types.
- Verified eligibility and coverage, facilitating accurate claims processing and cost containment.
- Resolved claims-related inquiries and escalations through effective communication with internal teams.
- Trained junior staff on complex claims, enhancing team proficiency and cohesion.
- Identified cost management opportunities, providing recommendations to management for improvement.
- Analyzed complex claims for compliance with company policies and processing accuracy.
Education
Associate of Applied Science - Early Childhood Care And Education
Kaplan University
Davenport, IA05-2013
Skills
- Data analysis and visualization
- Report generation and validation
- Data management tools
- Claims processing
Timeline
Senior Claim Data Specialist
Aetna, a CVS Health
05.2025 - Current
Senior Claims Benefit Specialist
Aetna, a CVS Health
09.1998 - 05.2025
Associate of Applied Science - Early Childhood Care And Education
Kaplan University