Kate Zanghi
Lancaster
Summary
Business professional with comprehensive background in the self-funded healthcare system. Experienced with leveraging data analysis to inform business decisions, gather requirements, and optimize processes. Utilizes critical thinking to identify inefficiencies and recommend practical solutions. Track record of collaborating with cross-functional teams to achieve project goals and enhance operational performance.
Overview
10
10
years of professional experience
Work History
Business Analyst
Nova Healthcare Administrators
03.2022 - Current
- Analyzes existing systems and processes, identifying areas for improvement.
- Develops comprehensive business requirements documents to guide project implementations.
- Collaborates with cross-functional teams to streamline operational workflows and enhance efficiency.
- Creates high-quality documentation to support training efforts, helping employees fully understand new systems and procedures.
- Manages multiple concurrent tasks in a fast-paced environment.
- Produces comprehensive documents outlining the scope of work for projects.
- Builds relationships with internal customers to ensure successful project outcomes.
- Utilizes SQL reporting, critical thinking skills, and attention to detail to troubleshoot production problems.
- Meets deadlines while maintaining high-quality deliverables.
Operations Supervisor
Nova Healthcare Administrators
05.2020 - 03.2022
- Successfully managed day-to-day operations of a large team, providing guidance and leadership to ensure efficient workflow.
- Trained employees in job-specific tasks and evaluated continuing education needs to improve team performance.
- Conducted regular performance reviews and provided feedback to team members.
- Supervised direct reports and enforced adherence to established procedures and deadlines.
- Collaborated with cross-functional teams to develop innovative solutions for process improvement.
Quality Assurance Auditor
Nova Healthcare Administrators
11.2018 - 05.2020
- Monitored claims and customer service to ensure accuracy.
- Supported all self-funded lines of business within the company, including customer service, claims, and enrollment.
- Implemented changes in processes or systems based on audit results and conducted follow-up reviews as needed.
- Documented test plans, protocols, observations, reports according to company guidelines.
- Trained personnel in proper techniques for conducting claims and call auditing.
- Provided recommendations based on findings to improve operations within department or across multiple departments to enhance overall performance and efficiency.
- Consistently met and exceeded department standards.
Claims Analyst
Nova Healthcare Administrators
03.2016 - 11.2018
- Researched and corrected rejected claims using established processes.
- Assumed responsibility for self-funded medical, dental, and vision claims for assigned groups within the team.
- Trained newly onboarded analysts on claims processing, policies, and procedures.
- Utilized 'big picture' thinking and understood downstream effects.
- Consistently met and exceeded audit and production goals each month.
- Interpreted healthcare plans, benefits, coverage limits, exclusions and other policy provisions to ensure accurate reimbursement of services rendered.
Education
High School Diploma -
Lancaster Central Schools
Lancaster, NYSkills
- Focus and Follow-Through
- Operational Efficiency
- Healthcare Terminology
- Critical thinking
- Data analysis
- Communication
- Process improvement
- Requirements Gathering
- User acceptance testing
Timeline
Business Analyst
Nova Healthcare Administrators
03.2022 - Current
Operations Supervisor
Nova Healthcare Administrators
05.2020 - 03.2022
Quality Assurance Auditor
Nova Healthcare Administrators
11.2018 - 05.2020
Claims Analyst
Nova Healthcare Administrators
03.2016 - 11.2018
High School Diploma -
Lancaster Central Schools
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