Kaitlyn Woodside
Summary
Results-driven professional with extensive experience in data manipulation, statistical analysis, and data visualization. Proven ability to leverage advanced analytical techniques to uncover trends and drive informed business strategies. Strong track record of applying critical thinking skills to tackle complex problems and deliver actionable insights that enhance decision-making processes. Committed to transforming data into strategic opportunities that propel organizational success.
Overview
6
6
years of professional experience
Work History
Claims Analyst
EviCore
01.2024 - Current
- Provider & Health Plan Refunds analysis
- Research and resolve high-dollar, escalated, and complex claim issues within established timeframes to ensure accurate provider and health plan refunds.
- Identify error trends across claim workflows and communicate findings to appropriate teams to drive process improvement and prevent recurrence.
- Collaborate closely with cross-functional departments to maintain proper workflows and support seamless claim resolution.
- Communicate with internal agents, service providers, and health plans via phone and written correspondence to investigate and resolve claim discrepancies.
- Review and adjudicate refund requests from providers and health plans independently, providing clear and accurate resolutions.
- Utilize multiple systems, including PCM, MCRS, SQL, health plan portals, and payment platforms; introductory experience with ECRM.
- Trained in both Provider Refunds and Health Plan Refunds, supporting a broad range of departmental needs.
- Serve as a moderator for Provider Refunds training, assisting in onboarding and guiding new hires through learning labs.
- Support departmental needs by rotating across tasks and assisting with escalated issues at the direction of SMEs and supervisors.
Mental Health Nurse Tech
Williamson Medical Center
06.2023 - 01.2024
- Collaborated with multidisciplinary teams to ensure comprehensive patient care and effective treatment strategies.
- Responsible for aiding nurses and hospital staff with routine tasks, such as taking vitals and patient interactions.
- Monitored patient progress, adjusted interventions based on observations, and documented changes in behavior.
- Adapted quickly and effectively to changing environments while maintaining professional standards of practice at all times.
- Respected the privacy rights of all individuals served by adhering strictly to HIPAA regulations and guidelines at all times.
Student-Athlete
Lipscomb University
08.2019 - 05.2023
- Developed time management skills by balancing academic responsibilities with rigorous athletic commitments.
- Collaborated with teammates to create a supportive atmosphere that encouraged growth, camaraderie, and sportsmanship.
- Displayed resilience under pressure situations during competitions that positively impacted overall team results.
- Incorporated innovative ideas into daily practice plans that improved overall performance.
- Successfully managed multiple tasks simultaneously while maintaining high standards of excellence and integrity.
- Mentored athletes, providing guidance on skill development and personal growth within the sport.
- Participated in community service projects connected to the athletics program, demonstrating commitment to social responsibility and character development.
Supervisor of Operations
The Grove Living
04.2020 - 08.2022
- Responsible for maintaining a safe and healthy work environment by establishing and enforcing standards of practice.
- Successfully managed scheduling and coordinating events, as well as attending meetings, and contributed to increasing revenue.
- Maintained professional working relationships, and promoted open lines of communication with staff.
- Conducted regular meetings with team members to discuss progress, address concerns, and set goals.
- Resolved conflicts between employees and departments.
- Reviewed customer and staff feedback to improve operational strategies and eliminate obstacles.
- Seasonal
Education
Master's Degree - Healthcare Administration
Louisiana State University in Shreveport
Shreveport, LA08-2025
Bachelor of Science (B.S.) - Psychology
Lipscomb University
Nashville, TN05-2023
Skills
- Microsoft Office Suite
- Skilled in SQL
- Claims trend analysis
- Data interpretation
- Root-cause analysis
- Time management
- Attention to detail
- Teamwork and collaboration
- Excellent communication
Timeline
Claims Analyst
EviCore
01.2024 - Current
Mental Health Nurse Tech
Williamson Medical Center
06.2023 - 01.2024
Supervisor of Operations
The Grove Living
04.2020 - 08.2022
Student-Athlete
Lipscomb University
08.2019 - 05.2023
Master's Degree - Healthcare Administration
Louisiana State University in Shreveport
Bachelor of Science (B.S.) - Psychology
Lipscomb University