Katherine Henning
Etna,OH
Summary
Dedicated healthcare administrative professional with extensive experience in appeals management, claims processing, and healthcare operations. Expertise in streamlining workflows and ensuring compliance has consistently improved patient and provider communication. Proven leadership skills drive collaboration and deliver impactful results, supported by strong conflict resolution, process optimization, and strategic planning abilities. Recognized for reliability and fostering a productive work environment, committed to delivering exceptional service and operational excellence.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Appeals and Claims Risk Supervisor
MedBen
Newark, OH
06.2025 - Current
- Supervised daily operations, ensuring adherence to quality standards and regulatory compliance.
- Implemented process improvements that enhanced workflow efficiency and reduced operational delays.
- Trained and mentored staff, fostering a culture of continuous improvement and professional development.
- Developed training materials for new hires, streamlining onboarding and enhancing team productivity.
- Collaborated with cross-functional teams to resolve operational challenges and optimize service delivery.
Lead Appeals Coordinator
MedBen
Newark, OH
02.2022 - 06.2025
- Oversee and process healthcare appeals, ensuring compliance with corporate and statutory guidelines. Facilitate external reviews and manage documentation for appeals and complaints. Manage and communicate the consistent industry changes in appeal processes, insurance policies and procedures.
- Log and process appeals, including ERISA and non-ERISA cases, adhering to regulatory standard.
- Review and evaluate appeal cases utilizing the insurance policies and procedures to determine resolution.
- Draft and send disposition letters, maintaining detailed records of appeal activities.
- Coordinate with external review agencies, cost containment vendors (CCV), pharmacy benefit managers and internal departments to ensure fair, accurate and timely resolution.
- Review and respond to Department of Insurance complaints, ensuring regulatory compliance.
- Assist claims department with provider communications and claim reprocessing, as needed.
- Support Stop Loss claims processing and reimbursement activities.
- Cross- trained in multiple departments to enhance operational flexibility.
Claims Risk Coordinator
MedBen
Newark, OH
12.2017 - 02.2022
- Managed high-risk medical claims, supporting cost containment and claims review activities. Liaised with vendors and healthcare providers to facilitate timely and accurate claim adjudication.
- Reviewed large and high-risk claims, ensuring proper documentation and compliance.
- Coordinated with utilization review vendors and pharmacy benefit managers for prior authorizations.
- Monitored claim batches and facilitated forms and processed payments for CCV fees.
- Reviewed and adjudicated complex claims, including transplant and disability claims.
- Generated weekly reports on high priority claims to ensure prompt handling.
- Supported stop loss renewal procedures and subrogation activities.
- Provided case management updates and maintained accurate records in the system.
Private Caregiver/Companion
Self-employed
Bexley, OH
06.2016 - 12.2017
- Provided personal care and support to individuals with medical needs, assisting with daily activities and medical appointments.
- Assisted clients with bathing, cooking, transportation, and dialysis treatments.
- Trained new caregivers, ensuring quality and consistency of care.
Receptionist/Office Assistant
Dr. Bressler, Schaffer, Bressler, Inc.
Columbus, OH
05.2015 - 06.2016
- Supported medical office operations, coordinated patient visits, and facilitated communication between patients and healthcare providers.
- Scheduled patient visits and surgeries, ensuring smooth clinic operations.
- Assisted with medical information requests and insurance documentation.
- Submitted precertification and prior authorization requests with medical records to the utilization review vendors and/or insurance companies.
- Greeted patients, verified information, and managed patient records.
Patient Care Assistant
Grant Medical Center
Columbus, OH
02.2012 - 05.2015
- Provided bedside care and support in a hospital setting, specializing in stroke care.
- Monitored vital signs and glucose levels.
- Assisted with patient admissions, discharges, and bedside procedures.
- Collaborated with healthcare team to ensure comprehensive patient care.
- Maintained detailed care logs and documentation.
Education
Associates of Applied Science - Health Service Technology
Central Ohio Technical College (COTC)
Newark, OH08-2017
High School Diploma - undefined
Watkins Memorial High School
Pataskala, OH06-2010
Skills
- Exceptional understanding of medical insurance procedures
- Ability to interpret complex documents
- Time Management
- Healthcare Compliance
- Insurance Verification
- NCCN (National Comprehensive Cancer Network) Guidelines
- CMS (Centers for Medicare & Medicaid Services) Guidelines
- Claims Reconciliation
- Utilization Review
- Computer literacy
- Communication
- Documentation Review
- Leadership
- Healthcare
- Windows 4
- Organization
- Analytics
- Attention to detail
- Coordinator
- Medical Terminology
- Insurance verification
- Medical Records Management
- Microsoft Office Suite
- Epic EMR
- Data Analysis
- AAPC
- Medical Coding (ICD-10, CPT, HCPCS)
- Clerical Experience
- Medical Scheduling
- Vital Signs
- Training and mentoring
- Goal oriented
- Staff management
- Customer service
- Employee motivation
- Decision-making
- Complex Problem-solving
- Strategic planning
- Analytical thinking
Accomplishments
- Appeals Management
- Claims Processing
- Medical Records Review
- Healthcare Operations
- Claims Risk Coordination
- Medical Billing & Coding
- Regulatory Compliance (HIPPA, ISO)
- Vendor & Stakeholder Coordination
- Customer Service & Communication
- Optimized appeals workflow, reducing processing time by 15%.
- Led cross-departmental training, improving team efficiency and accuracy.
- Managed complex appeals and claims, ensuring compliance with statutory guidelines.
Certification
- Certified Patient Care Assistant (CPCA)
- Certification, American Academy of Professional Coders (AAPC), 2017-07
Languages
English
Full Professional
Timeline
Appeals and Claims Risk Supervisor
MedBen
06.2025 - Current
Lead Appeals Coordinator
MedBen
02.2022 - 06.2025
Claims Risk Coordinator
MedBen
12.2017 - 02.2022
Private Caregiver/Companion
Self-employed
06.2016 - 12.2017
Receptionist/Office Assistant
Dr. Bressler, Schaffer, Bressler, Inc.
05.2015 - 06.2016
Patient Care Assistant
Grant Medical Center
02.2012 - 05.2015
High School Diploma - undefined
Watkins Memorial High School
Associates of Applied Science - Health Service Technology
Central Ohio Technical College (COTC)