1. Catherine
Doty
1010 S 62nd ST
Tacoma WA 98408
206 755 1344
mosayik@gmail.com
EXPERIENCE
Group Health Cooperative, Tukwila, WA
Appeals Coordinator
1997 – May 2014
● Responsible for the management of health plan appeals
and grievances cases for all lines of business.
● Investigated cases using claims system, electronic
medical records, chart notes, coverage contracts, and
external resources.
● Collaborated with review physicians and staff from all
levels and areas of the organization.
● Facilitated Appeal Committee hearings, responded to OIC
complaints, and maintained highest level of compliance
standards at all times.
● Comfortable working with diverse populations and
patients.
● Able to communicate complex or sensitive information in
an empathetic and easy to understand manner.
Virginia Mason-Group Health Alliance, Seattle, WA
Customer Service Representative
1996 - 1997
● Benefit quotes, referral authorizations, claim resolution,
and investigation of complaints.
● Knowledge requirements included; medical terminology,
CPT/ICD coding, health plan policy interpretation.
● Featured in health plan newsletter for customer service
excellence.
Group Health Cooperative, Seattle, WA
Coordination of Benefits Specialist
1995 - 1996
● Ensured appropriate payer responsibilities.
● Production and analysis of reports.
● Appointed lead of unit; Responsible for staff production
and work assignments.
Aetna, Seattle, WA
Customer Service Representative
Claims Processing
1988 -1993
● Medical terminology, medical and dental coding, benefit
interpretation, claims processing, and customer service.
REFERENCES
