Catherine Harvey
Nahunta,GA
Summary
Detail-oriented healthcare professional with extensive experience in insurance verification, prior authorizations, and patient access services within multi-site health systems. Proven ability to navigate complex payer requirements across commercial, federal, and state plans while ensuring compliance with regulatory standards, including HIPAA. Skilled in reviewing medical necessity, submitting and tracking authorization requests, and resolving insurance denials through effective collaboration with providers and billing teams. Adept at utilizing EMR/EHR systems to support accurate documentation, streamline workflows, and optimize reimbursement processes. Recognized for strong communication, problem-solving, and organizational skills, with a commitment to delivering excellent patient financial guidance and ensuring seamless coordination between patients, providers, and insurance entities.
Overview
11
11
years of professional experience
Work History
Medical Office Assistant
Southeast Georgia Health System
06.2025 - Current
- Gathered, verified, and accurately entered patient health records and demographic information to complete registration and ensure readiness for clinical and surgical services.
- Obtained and processed insurance authorizations and referrals in compliance with commercial, federal, and state payer requirements.
- Utilized electronic medical record (EMR) and scheduling systems to verify medical necessity and ensure required documentation was complete prior to procedures.
- Created cost estimates for self-pay patients and assisted with charity care applications, providing clear financial guidance and documentation support.
- Maintained incoming fax queues for referrals, authorizations, and insurance denials, ensuring timely follow-up and resolution.
- Operated office systems including computer software, telephone, and fax equipment to support daily clinical and administrative operations.
- Collaborated with multidisciplinary health system departments to facilitate seamless patient care coordination.
- Adhered strictly to HIPAA regulations and organizational policies to maintain confidentiality of patient and practice information.
- Demonstrated professional, courteous, and effective interpersonal communication with patients, providers, and healthcare team members.
Patient Access Rep Specialist II
Baptist Medical Center
09.2024 - Current
- Registered patients accurately and efficiently in multiple healthcare systems, ensuring all patient information was up-to-date and accurate.
- Seek appropriate resources to resolve issues about the type, date, location of appointments.
- Schedules patients appointments in a manner that most efficiently utilizes the patients time and clinical resources.
- Maintained service excellence in all patient interactions.
- Articulated compliance documentation and ensured all required patient consent forms were completed in accordance with regulatory requirements.
- Ensured strict adherence to patient privacy and confidentiality, in compliance with HIPAA guidelines.
- Built and maintained professional relationships with clinical and non-clinical team members to foster a collaborative work environment.
- Indexed incoming referrals in a timely manner and requested authorizations.
- Scheduling coordinator for Congestive Heart Failure Clinic for three locations including managing providers schedules, coordinating patients appointments, making aware of any clinical needs prior to appointments.
Authorization Specialist/ Patient Care Assistant
Southeast Georgia Health System
11.2023 - 09.2024
- Medical Necessity Review: Expertly review and interpret physician orders and patient medical records to assess medical necessity and accuracy for prior authorization requests, ensuring compliance with healthcare regulations.
- Insurance Verification: Proficiently contact insurance providers to verify patient coverage and benefits for specific procedures, utilizing a keen aptitude for detail and accuracy.
- Authorization Requests: Submit comprehensive authorization requests through electronic health record (EHR) systems, online portals, and telephone communications. Monitor and track the status of submissions, proactively following up to resolve any delays or issues.
- Patient Communication: Effectively communicate with patients and physicians regarding the status of authorizations, clearly articulating any additional information or actions required. Maintain an open line of communication to enhance patient understanding and satisfaction.
- Capsule Endoscopy Administration: Coordinate and confirm Capsule Endoscopy appointments, providing thorough instructions to patients during an 8-hour study. Download and prepare patient results for provider review, ensuring accuracy and clarity.
- Pre-Authorization Processes: Manage pre-authorization for STAT radiology procedures and Esophageal Manometry orders, guiding patients on locations and necessary instructions for their appointments.
- Veteran Services Coordination: Collaborate with Care in the Community to extend authorizations for Veterans’ procedures, demonstrating strong advocacy and support.
- Regulatory Compliance: Adhere to all healthcare regulations, including HIPAA, to ensure the confidentiality and privacy of patient information.
- Claims Resolution: Work closely with the business office to appeal denials, schedule peer-to-peer reviews with providers, and resolve outstanding billing issues.
- Patient Inquiry Management: Address patient inquiries related to procedures and financial questions, providing clear and accurate information to enhance patient experience.
- Scheduling: Efficiently schedule patients in the clinic as needed, utilizing strong organizational and multitasking skills.
- Software Proficiency: Utilize Microsoft Office products (Word, Excel, Outlook, PowerPoint) to document processes, analyze data, and present information clearly and effectively.
Patient Support Specialist
Southeast Georgia Health System
07.2021 - 08.2022
- Patient Care and Assessment: Assisted technologists in providing comprehensive patient care before, during, and after imaging exams, ensuring high standards of comfort and safety, which are essential for effective billing processes.
- Supply Management: Consistently maintained necessary supply levels for diagnostic services, facilitating uninterrupted workflow in Imaging Services, thus supporting timely billing and collection operations.
- Patient Transport: Safely transported patients to and from Imaging Services, prioritizing comfort and safety, contributing to an overall positive experience that aids in timely claims processing.
- Privacy and Safety Compliance: Ensured patient and family privacy by conducting thorough safety screenings and adhering to compliance regulations, essential for maintaining accurate billing practices.
- Effective Communication: Fostered open communication with patients, the care team, hospital staff, and external organizations, enhancing collaboration that supports billing inquiries and resolutions.
- Data Management: Efficiently formatted and uploaded digital images into the Picture Archiving and Communication System (PACS) and utilized electronic medical records (EMR) for precise charting and documentation, critical for accurate billing and collections.
- Clerical Support: Compiled and maintained data for various reports, ensuring all information was accurate and accessible for administrative purposes, supporting effective billing functions.
- Software Proficiency: Utilized clerical software and Microsoft Office products (Word, Excel, Outlook, PowerPoint) to perform administrative duties efficiently, enhancing departmental operations and contributing to prompt payment processes.
Clinical Coordinator/ Orthodontic Dental Assistant
Bangor Braces
09.2017 - 05.2021
- Clinic Operations Management: Independently coordinated a fast-paced orthodontic clinic, prioritizing tasks and managing a variety of responsibilities to ensure smooth operations, essential for efficient billing and collection processes.
- Data Entry and Documentation: Accurately entered patient records and treatment information into electronic databases, maintaining meticulous documentation that supports billing accuracy and compliance.
- Patient Communication: Responded to telephone and written inquiries from patients and dental practices, addressing concerns and providing information to enhance patient satisfaction, which is vital for resolving billing issues.
- Documentation Preparation: Prepared and typed letters, reports, and memorandums related to patient care and clinic operations, ensuring clear and organized communication that aids in billing inquiries and claims resolution.
- Record Compilation: Compiled and maintained comprehensive data for various reports, tracking patient progress and treatment outcomes, which supports clinical decision-making and accurate billing practices.
- Training and Supervision: Participated in the hiring process for new dental assistants, made staffing recommendations, and trained new staff on administrative and clinical procedures, fostering a cohesive team environment that enhances operational efficiency.
- Inventory Management: Supervised clinic inventory levels and ordered supplies, ensuring necessary materials were always available for patient care, contributing to uninterrupted service and timely billing.
- Emergency Handling: Managed orthodontic emergency appointments independently, demonstrating problem-solving skills and effective patient care under pressure, reinforcing the importance of prompt and efficient operations.
- Sterilization and Compliance: Ensured proper disinfecting and instrument cleaning throughout the operatory, adhering to safety protocols, which is critical for maintaining compliance in billing related to healthcare services.
- Software Proficiency: Utilized Microsoft Office products (Word, Excel, Outlook, PowerPoint) for effective communication and administrative tasks, contributing to improved operational efficiency and billing accuracy.
Mental Health Support Specialist
MAS Homecare
Bangor, ME
01.2017 - 09.2017
- Goal-Oriented Support: Worked with children experiencing serious emotional disturbances and those with intellectual disabilities or autism to help them achieve defined developmental goals through targeted interventions.
- Data Entry: Accurately entered and maintained client information and progress notes in electronic databases, ensuring comprehensive records for effective tracking and reporting.
- Client Communication: Responded to telephone and written inquiries from parents, guardians, and other stakeholders, providing information and support regarding services and progress.
- Documentation Preparation: Prepared and typed letters, reports, and memorandums related to client goals and progress, ensuring clear communication among team members and families.
- Data Compilation: Compiled and maintained data for various reports on client outcomes and program effectiveness, contributing to ongoing assessment and improvement efforts.
- Administrative Support: Utilized clerical software programs to complete administrative duties, enhancing the efficiency of program operations and client management.
Mental Health Support Specialist
Charlotte White Center
Bangor, ME
06.2016 - 08.2017
- Therapeutic Support: Provided personal supervision and therapeutic support to individuals with severe and persistent mental illness, fostering a supportive environment for skill development.
- Daily Living Skills Development: Assisted clients in developing and maintaining essential daily living skills, promoting their overall health, safety, and independence.
- Data Management: Accurately entered client information and treatment notes into electronic databases, ensuring thorough and up-to-date records for effective case management.
- Communication: Responded to telephone and written inquiries from clients and their families, addressing concerns and providing information to facilitate their understanding of available resources.
- Documentation Preparation: Prepared and typed letters, reports, and memorandums related to client progress and care plans, ensuring clear communication among the care team.
- Report Compilation: Compiled and maintained data for various reports, tracking client outcomes and program effectiveness to support ongoing assessment and improvement.
- Administrative Support: Utilized clerical software programs to complete various administrative duties, contributing to the efficient operation of the mental health program.
Bakery Cafe Associate
Panera Bread
Biddeford, ME
07.2015 - 06.2016
- Customer Service Excellence: Provided friendly and efficient service during customer interactions, ensuring a positive shopping experience and fostering customer loyalty.
- Data Entry: Accurately processed transactions and entered sales data into the computer system, maintaining precise records of sales activity.
- Inquiry Response: Addressed customer inquiries both in-person and over the phone, providing information on products, services, and store policies to enhance customer satisfaction.
- Documentation Preparation: Prepared and maintained daily cash reports and transaction summaries, ensuring accurate financial documentation for the store.
- Report Compilation: Compiled data for weekly sales reports, assisting management in tracking performance and identifying trends.
- Clerical Support: Utilized point-of-sale systems and other clerical software to complete administrative duties, contributing to smooth store operations.
Bakery Cafe Associate
Little Caesars
Saco, ME
11.2014 - 07.2015
- Food Preparation and Service: Responsible for preparing and serving food items, ensuring high standards of quality and presentation while adhering to safety and sanitation guidelines.
- Equipment Operation: Operated kitchen equipment and maintained workstations to ensure efficiency and safety in food preparation and service.
- Sales Processing: Accurately rang up sales and processed transactions, managing cash and electronic payments while providing excellent customer service.
- Customer Interaction: Engaged with customers to take orders and address inquiries, fostering a welcoming environment and enhancing the overall dining experience.
- Cleaning and Maintenance: Maintained cleanliness and organization of workstations and dining areas, ensuring compliance with health and safety regulations.
- Data Entry and Reporting: Assisted in recording inventory levels and food sales data, contributing to inventory management and operational reporting.
- Clerical Support: Utilized point-of-sale systems to complete administrative tasks related to transactions and inventory tracking.
Education
Highschool Diploma -
Thornton Academy
Saco, ME06-2016
Skills
- Communication Skills
- Customer Service
- Data Entry Proficiency
- Organization Skills
- Problem-Solving Skills
- Technical Skills
- Time Management
- Adaptability
- Attention To Detail
- Team Collaboration
- Patient Registration and Access
- Data Entry and Healthcare Systems Proficiency
- Medical Coding (ICD-10, CPT, HCPCS)
- Referrals
- Authorizations
- Medical Terminology
- Insurance billing
Timeline
Medical Office Assistant
Southeast Georgia Health System
06.2025 - Current
Patient Access Rep Specialist II
Baptist Medical Center
09.2024 - Current
Authorization Specialist/ Patient Care Assistant
Southeast Georgia Health System
11.2023 - 09.2024
Patient Support Specialist
Southeast Georgia Health System
07.2021 - 08.2022
Clinical Coordinator/ Orthodontic Dental Assistant
Bangor Braces
09.2017 - 05.2021
Mental Health Support Specialist
MAS Homecare
01.2017 - 09.2017
Mental Health Support Specialist
Charlotte White Center
06.2016 - 08.2017
Bakery Cafe Associate
Panera Bread
07.2015 - 06.2016
Bakery Cafe Associate
Little Caesars
11.2014 - 07.2015
Highschool Diploma -
Thornton Academy