MISTI A. LITTLE
Plantation,FL
Summary
Seasoned collaborator experienced in meeting needs, improving processes and exceeding requirements in team environments. Diligent worker with strong communication and task prioritization skills.
Overview
16
16
years of professional experience
Work History
Business Analyst IV
WellCare Of North Carolina
02.2023 - Current
- Actively participated in team meetings to share knowledge, exchange ideas, address challenges, and collaborate on potential solutions.
- Assisted in developing documentation to support training efforts, helping employees fully understand new systems and procedures.
- Improved business processes by analyzing current practices and recommending optimization strategies.
- Collaborate in thorough review, investigation, and resolution of intricate claims, appeals, inquiries, and payment discrepancies.
- Conduct detailed analysis on provider projects and Provider Claims Calls
- Lead onboarding activities for new hires in regards to access and acquainting to department.
- Created multiple SharePoint sites for collaboration between teams.
FINANCE ANALYST II/FINANCE ANALYST III
SUNSHINE HEALTH
04.2019 - 02.2023
- Provides and performs financial analysis, and standard ad hoc reporting
- Design policies and procedures for department roles
- Perform financial modeling for business needs
- Financial impact analysis for SCAs and negotiated contracts
- Review and keep up to date with current State documentation
- Review of case reserves for authorizations and claim payments
- Working with different departments through integration of acquired company
- Med expense reporting.
- Strengthened internal communication between finance department and other business units, fostering collaboration towards shared objectives.
- Mentored team members on effective financial analysis techniques, promoting professional development within finance department.
- Enhanced, innovated and improved existing processes and controls to manage risk.
- Researched and analyzed 6 revenue items trend for accuracy and integrity during month end close
SALES ASSOCIATE
TORRID
07.2021 - 10.2022
- Merchandising in accordance with company floor set
- Receiving and maintaining weekly inventory shipments, 10+ daily
- Remembering customer's preferences
- Greeting customers and ensuring their needs are met through their shopping experience
- Completing web orders
- Assisting in training of new hires
- Retail software system navigation.
BUSINESS ANALYST II
MAGELLAN HEALTH
11.2018 - 04.2019
- Design policies and procedures based on state guidelines
- Delegating work based on department and company needs
- Implementation of new programs; testing, planning and training
- Managing inventory requirements
- Managed inventory for team of 3
- Configuration of new fee schedules and provider updates.
LEGAL/GOVT. AFFAIRS BUSINESS ANALYST II
SUNSHINE HEALTH
05.2018 - 11.2018
- Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems
- Perform detailed analysis on high-risk provider projects and Joint Operations Committee Calls
- Enhance performance management and operational reports related to business needs.
- Documentation for subpoena requests for members
BUSINESS ANALYST I, CLAIMS LIAISON II, CLAIMS LIAISON I
SUNSHINE HEALTH
03.2015 - 05.2018
- Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of new systems
- Perform detailed analysis on high-risk provider projects and Joint Operations Committee Calls
- Enhance performance management and operational reports related to business needs
- Training, at times in conjunction with other departments on processes, as well as training new hires
- Analyze trends among provider billing, reporting, and making recommendations based on analysis
- Creating user friendly SharePoint accessible for team and other departments for tracking purposes
- Reporting and analyzing inventory
- Root cause analysis.
LEAD CLAIMS ANALYST, ADVANCED/BASIC CLAIMS ANALYST
CENTENE CORPORATION
02.2011 - 02.2015
- Assist in reviewing, investigating, adjusting and resolving complex claims, claims appeals, inquiries and inaccuracies in payment of claims
- Oversee claims quality reviews for accuracy, document results and identify trends and systemic root cause analysis
- Assist in creating workflows for department and support team members in understanding changes in work processes
- Primary contact for team, for the plan and other departments in researching, collecting background information and documentation, to address various issues
- Assist supervisor to research and determine status of claims
- Maintain records and reports
- Assist in meeting department production and quality standards
- Apply policy and provider contract provisions to determine if claims processing
- Meet department production and quality standards.
ASSISTANT MANAGER, KEY HOLDER, SALES ASSOCIATE
HOT TOPIC
09.2008 - 03.2011
- Opening and closing shift manager
- Conducting interviews
- Merchandising in accordance with company floor set
- Receiving and maintaining inventory shipments
- Auditing
- Employee reviews
- Resolving customer complaints.
MANAGER
KRANZ FLORISTS
04.2010 - 02.2011
- Creating sales reports and analysis for tracking
- Filing and Organizing sales orders
- Performing bi-weekly payroll for approximately 15 employees
- Interviews, employment and termination of employment
- Employee reviews
- Auditing
- Resolving customer complaints.
Education
Bachelor of Science - Supervision And Management
Broward College
Fort Lauderdale, FL05.2024
Associate of Arts -
Broward College
Fort Lauderdale, FL08.2023
LICENSE IN SKINCARE AND MAKEUP ARTISTRY -
CORTIVA INSTITUTE
Pompano Beach, FL07.2017
High School Diploma -
LIBBY SENIOR HIGH
Libby, MT06.2007
Skills
- Data Analysis
- Requirements Gathering
- Microsoft Excel Mastery
- KPI Tracking
- Quality Assurance
- Customer Communication
- Operations Analysis
- Revenue development
- SQL and Databases
- Team Collaboration
- Process Improvement
Timeline
Business Analyst IV
WellCare Of North Carolina
02.2023 - Current
SALES ASSOCIATE
TORRID
07.2021 - 10.2022
FINANCE ANALYST II/FINANCE ANALYST III
SUNSHINE HEALTH
04.2019 - 02.2023
BUSINESS ANALYST II
MAGELLAN HEALTH
11.2018 - 04.2019
LEGAL/GOVT. AFFAIRS BUSINESS ANALYST II
SUNSHINE HEALTH
05.2018 - 11.2018
BUSINESS ANALYST I, CLAIMS LIAISON II, CLAIMS LIAISON I
SUNSHINE HEALTH
03.2015 - 05.2018
LEAD CLAIMS ANALYST, ADVANCED/BASIC CLAIMS ANALYST
CENTENE CORPORATION
02.2011 - 02.2015
MANAGER
KRANZ FLORISTS
04.2010 - 02.2011
ASSISTANT MANAGER, KEY HOLDER, SALES ASSOCIATE
HOT TOPIC
09.2008 - 03.2011
Bachelor of Science - Supervision And Management
Broward College
Associate of Arts -
Broward College
LICENSE IN SKINCARE AND MAKEUP ARTISTRY -
CORTIVA INSTITUTE
High School Diploma -
LIBBY SENIOR HIGH
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