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Katheryn EplingKE
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Katheryn Epling

@katherynepling

Pharmacy Operations Specialist II at Weight Watchers Clinic / Sequence who raised denial overturn rates to approximately 40% through payer-aligned appeal strategy.

United States
Message

At Weight Watchers Clinic / Sequence, I increased denial overturn rates to approximately 40% through payer-aligned appeal strategy and redesigned appeals triage to reduce unnecessary escalations and delays. I also partnered with clinicians and engineering teams on complex cases and workflow improvements.

At Priority Health, I managed daily prior authorization and coverage cases, supporting patients and providers through denials and access barriers. Earlier, at Ventegra, I achieved 99% CSAT through patient advocacy and insurance navigation, and trained and onboarded new hires.

Experience

Work history, roles, and key accomplishments

WS

Pharmacy Operations Specialist II

Weight Watchers Clinic / Sequence

Sep 2023 - May 2026 (2 years 8 months)

Increased denial overturn rates to approximately 40% through payer-aligned appeal strategy and analysis of denial patterns. Redesigned appeals triage and workflows, served as an SME and mentor, and collaborated with engineering teams to improve PA and appeals operations.

Education

Degrees, certifications, and relevant coursework

HS

Hartselle High School

Advanced Diploma, General Studies

Completed an Advanced Diploma from Hartselle High School in 2009.

Tech stack

Software and tools used professionally

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