Kathryn E Booker
Harrisburg,PA
Summary
Detail-oriented professional with expertise in claims processing and regulatory compliance. Proven ability to collaborate effectively with teams to resolve appeals and enhance customer service experiences.
Overview
22
22
years of professional experience
Work History
Assistant Daycare Teacher
UGRO Learning Centers
Harrisburg, PA
03.2026 - Current
- Assisted in implementing daily lesson plans to enhance children's learning experiences.
- Supported classroom management by maintaining a safe and engaging environment for children.
- Collaborated with lead teachers in organizing educational activities and special events.
- Fostered positive relationships with children, promoting social interaction and emotional development.
- Supported the lead teacher in monitoring student behavior, enforcing rules and addressing issues as they arose.
- Maintained clean, neat and hazard-free areas to protect kids, personnel and families.
- Sanitized dishes, tabletops, toys, and frequently touched surfaces to prevent spreading of germs.
- Provided lunchtime assistance to monitor children, assist with eating and serve food.
Appeals Specialist
Allied Benefit Solutions
Remote Position (Contract Employee)
07.2025 - 09.2025
- Reviewed and analyzed appeals for compliance with regulatory requirements.
- Assisted in preparing documentation for appeal processes, ensuring accuracy and completeness.
- Communicated with clients to gather necessary information for appeal submissions.
- Collaborated with internal teams to resolve complex appeals efficiently.
- Expedited resolution times for appeals cases by efficiently managing workload and prioritizing urgent matters.
- Maintained strict confidentiality of patient information in accordance with HIPAA regulations.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Benefit Enrollment Specialist
Commonwealth of PA
Harrisburg, PA
09.2024 - 06.2025
- Responded verbally or in writing to select inquiries from intra- and interdepartmental units, outside entities and family applicants
- Coordinated the development and maintenance of information technology to support program operations and monitor the tracking systems
- Maintained a general understanding of the Medical Assistance Program
- Identified claims processing system-related issues, communicated the issue to both program and technical staff
- Made updates and corrections for Managed Care enrollment based on reports and requests from MCO and other program offices
- Developed queries and prepared reports for analysis of reimbursement accuracy
Grievance and Appeals Coordinator II
Centene
Mechanicsburg, PA
01.2022 - 07.2024
- Coordinated appeals process, ensuring compliance with regulatory standards and internal guidelines.
- Reviewed and analyzed appeal cases, identifying key issues to facilitate resolution.
- Collaborated with cross-functional teams to enhance operational efficiency in appeals handling.
- Maintained accurate documentation of appeal decisions and communicated outcomes effectively.
Grievance and Appeals Coordinator
Capital Blue Cross
Harrisburg, PA
11.2018 - 02.2020
- Coordinated appeals process to ensure timely resolution of member disputes.
- Reviewed and analyzed case files for compliance with regulatory requirements.
- Collaborated with clinical staff to gather necessary documentation for appeals.
- Educated members on appeal rights and procedures, enhancing member experience.
- Followed the privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information
- Maintained accurate records for work measurement and attendance
Claims Processor/Claims Adjuster
Highmark, Inc.
Camp Hill, PA
07.2012 - 11.2018
- Processed insurance claims efficiently, ensuring adherence to company policies and state regulations.
- Reviewed claim documentation for accuracy, identifying discrepancies and initiating corrections.
- Utilized claims processing software to track and manage the status of submissions effectively.
- Elevated issues to the next level of processing, as appropriate.
- Maintained accurate records for work measurement and attendance
Administrative Services Coordinator
Highmark, Inc.
Camp Hill, PA
07.2012 - 11.2018
- Coordinated administrative functions to optimize workflow and improve operational efficiency.
- Managed scheduling and logistics for meetings, ensuring effective resource allocation.
- Developed and maintained filing systems to enhance document retrieval processes.
- Implemented process improvements that streamlined office operations and reduced redundancies.
Teller/Customer Service Representative
Metro Bank
Harrisburg, PA
10.2010 - 07.2012
- Processed customer transactions accurately and efficiently.
- Assisted customers with account inquiries and product selection.
- Maintained cash drawer integrity through meticulous balancing procedures.
- Collaborated with team members to enhance customer service experiences.
Server
Arooga's Grille House and Sports Bar
Harrisburg, PA
05.2008 - 07.2012
- Provided exceptional customer service, ensuring a positive dining experience for all guests.
- Collaborated with kitchen staff to accurately process orders and maintain timely food delivery.
- Trained new servers on operational procedures and best practices for guest interaction.
Consultant
Giotti's Italian Restaurant
Harrisburg, PA
09.2005 - 05.2008
- Assisted the owner with the startup of a new full-service restaurant
- Analyzed customer feedback to enhance service quality and menu offerings.
- Implemented and trained staff on a new server ordering/payment system, improving customer experience and table turnover rates.
Camp Counselor/Latch Key Counselor
YMCA
Harrisburg, PA
08.2004 - 08.2005
- Supervised group activities, ensuring safety and engagement among campers.
- Facilitated daily recreational programs, promoting teamwork and social skills development.
- Assisted in planning and executing themed events, enhancing camper participation.
- Provided guidance and support to campers, fostering a positive camp environment.
Education
High School Diploma -
Central Dauphin High School
Harrisburg, PA06-2005
Skills
- Transactions reconciliation
- Claims processing software
- Regulatory compliance
- Medical terminology
- Insurance regulations
- Claims adjustment
- Microsoft office
- Customer service
- Organizing and prioritizing work
- Teamwork and collaboration
- Multitasking
- Excellent communication
- Effective communication
- Adaptability and flexibility
Timeline
Assistant Daycare Teacher
UGRO Learning Centers
03.2026 - Current
Appeals Specialist
Allied Benefit Solutions
07.2025 - 09.2025
Benefit Enrollment Specialist
Commonwealth of PA
09.2024 - 06.2025
Grievance and Appeals Coordinator II
Centene
01.2022 - 07.2024
Grievance and Appeals Coordinator
Capital Blue Cross
11.2018 - 02.2020
Claims Processor/Claims Adjuster
Highmark, Inc.
07.2012 - 11.2018
Administrative Services Coordinator
Highmark, Inc.
07.2012 - 11.2018
Teller/Customer Service Representative
Metro Bank
10.2010 - 07.2012
Server
Arooga's Grille House and Sports Bar
05.2008 - 07.2012
Consultant
Giotti's Italian Restaurant
09.2005 - 05.2008
Camp Counselor/Latch Key Counselor
YMCA
08.2004 - 08.2005
High School Diploma -
Central Dauphin High School