CAROLYN E. BRANCH
HealthCare Management
Hillside,IL
Summary
Insightful Manager with experience directing and improving operations through effective employee motivational strategies and strong policy enforcement. Proficient in best practices, market trends and regulatory requirements of industry operations. Talented leader with analytical approach to business planning and day-to-day problem-solving.
Overview
18
18
years of professional experience
2
2
years of post-secondary education
3
3
Certifications
Work History
RCM Supervisor
Regent ASC Surgical Center
Westchester, IL
08.2022 - Current
- Monitored workflow to improve employee time management and increase productivity.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
- Evaluated employee performance and coached and trained to improve weak areas.
- Maintained clean and well-organized production areas to avoid violations or unnecessary work delays due to hazards or inefficient layouts.
- Achieved results by working with staff to meet established targets.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Maintained compliance with company policies, objectives, and communication goals.
Insurance Recovery Specialist
Nationwide Credit & Collections
Oak Brook, IL
07.2020 - 08.2020
- Completed insurance verification
- Read and understood EOB’s, medical records, and all correspondence received from an insurance company
- Contacted insurance companies via the telephone regularly
- Utilized online web applications including EPIC, One Source, and various insurance companies to complete follow up
- Bill/Re-bill various payers
- Appeal claims when necessary.
Medical Billing Manager
Heartland Health Centers
Chicago, IL
04.2018 - 03.2020
- Lead a team of eight staff members handling up to $7 million in monthly reimbursements
- Certified Medical Biller and Coder authorized to code procedures and manage patient charts
- Established an insurance verification and pre-authorization system to determine eligibility thereby decreasing rejections and denials by more than 75%
- Reconcile major insurance payers’ statements and payments
- Enforce operational compliance with state and federal laws and Managed Care Organizations’ standards
- Manage corrected claims insurance and schedule claims for payments
Medical Billing Supervisor
03.2016 - 04.2018
- Served as the first point of contact for all litigation including workers’ compensation, bankruptcies, medical malpractice lawsuits, and auto accidents; provided detailed reports for attorneys and testified in court on behalf of the organization
- Negotiated all insurance contracts to ensure in-network coverage for patients including workers’ compensation
- Supervised a team of eight staff members handling all training and issue resolution
- Proactively identified resolved complex issues impacting operations management and business direction
- Monitored multiple including databases Centricity, Epic, and Alert MD to monitor company inventory
- Oversaw various billing projects from conceptualization to completion
Senior and Lead Biller
10.2012 - 03.2016
- Created the secondary and tertiary Standard Operating Procedure to increase revenue and patient base
- Built and implemented new training and updated existing training for staff insubordinate and peer roles
- Prepared daily production reports for management and monthly encounter and revenue reporting for Chief Executive Officer
- Facilitate patient accounting operations from claim submittal to payment reimbursement
Patient Accounting/Followup Representative
University of Illinois, Chicago Medical Center
Chicago, IL
01.2005 - 10.2012
- Bills insurance for Medicare, Public Aid, and all Commercial claims
- Update patient insurance eligibility
- Facilitate patient accounting operations by submittal of clean claims to third party payers through electronic transmission and paper processes ,
- Responsible for overall billing tasks in regard to payment, editing and processing
- Maintain organization of medical record management system process
- Make adjustments and post cash payments from third party payers and self pay patients
- Research denial and rejection EOB for corrections and review
- Maintain consistent collection follow-up with representatives of insurance companies or self-insured groups by phone or mail regarding accounts with outstanding balances.
Education
Bachelor of Science - Technical Business
DeVry University
Certificate: Medical Insurance Billing - undefined
Olympia College
MBA - Health Administration
Keller Graduate School of Management
Naperville, IL 01.2021 - 12.2022
Skills
Staff Development & Trainingundefined
Certification
Project Management Certification - Association for Project Management (APM)
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
I think that only daring speculation can lead us further and not accumulation of facts.
Albert Einstein
Timeline
RCM Supervisor
Regent ASC Surgical Center
08.2022 - Current
MBA - Health Administration
Keller Graduate School of Management
01.2021 - 12.2022
Insurance Recovery Specialist
Nationwide Credit & Collections
07.2020 - 08.2020
Medical Billing Manager
Heartland Health Centers
04.2018 - 03.2020
Medical Billing Supervisor
03.2016 - 04.2018
Senior and Lead Biller
10.2012 - 03.2016
Patient Accounting/Followup Representative
University of Illinois, Chicago Medical Center
01.2005 - 10.2012
Bachelor of Science - Technical Business
DeVry University
Certificate: Medical Insurance Billing - undefined
Olympia College
Project Management Certification - Association for Project Management (APM)
Chartered Wealth Manager - American Academy of Financial Management (AAFM)
CPR Certification - AHA Healthcare Provider
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