Kathryn Smith
Kalispell,Montana
Summary
Possesses versatile skills in project management, problem-solving, and collaboration. Brings fresh perspective and strong commitment to quality and success. Recognized for adaptability and proactive approach in delivering effective solutions.
Overview
29
29
years of professional experience
Work History
Professional Development Educator
Logan Healthcare
03.2017 - 12.2024
- Built relationships and communicated with trainees to provide best learning techniques.
- Developed and implemented differentiated instruction strategies for diverse learners, ensuring individualized attention and success.
- Worked with staff members and leadership to design comprehensive and individualized plans to optimize trainee education.
- Developed materials and lesson plans to enhance skills for individual trainees.
Appeals and Grievance Specialist
New West Medicare Advantage Plan
11.2014 - 03.2017
- Processed and finalized appeals and grievances within agreed-upon turnaround time.
- Remained knowledgeable regarding company policies and procedures and current developments within operational departments.
- Completed in-depth investigations into issues pertaining to discipline and grievance management and recommended strategies.
- Submitted verbal and written notification to members and providers.
Appeals and Grievances Coordinator
Blue Shield of CA
01.2006 - 08.2014
- Processed and finalized appeals and grievances within agreed-upon turnaround time.
- Provided outreach for additional information for appeals and grievances.
Appeals Specialist
Aetna
03.1996 - 01.2006
- Collaborated with cross-functional teams to gather necessary documentation and evidence to support the appeals process.
- Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.
Education
Master of Arts - Adult Education, Corp Training
University of Phoenix
Tempe, AZ01-2013
Bachelor of Arts - Communications
University of Phoenix
Tempe, AZ01-2010
Skills
- Problem-solving
- Team collaboration
- Relationship building
- Conflict resolution
Timeline
Professional Development Educator
Logan Healthcare
03.2017 - 12.2024
Appeals and Grievance Specialist
New West Medicare Advantage Plan
11.2014 - 03.2017
Appeals and Grievances Coordinator
Blue Shield of CA
01.2006 - 08.2014
Appeals Specialist
Aetna
03.1996 - 01.2006
Master of Arts - Adult Education, Corp Training
University of Phoenix
Bachelor of Arts - Communications
University of Phoenix
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