GINA BRADEN
Parma,OHIO
Summary
Skilled healthcare revenue cycle professional with a long track record in medical billing, claims adjudication, and denial management. Strengths include complex claim review, payer communication, and appeal preparation. Dedicated to improving reimbursement outcomes and reducing payment delays.
Overview
1
1
Certification
28
28
years of professional experience
Work History
Coding and Reimbursement Specialist
THE CLEVELAND CLINIC
CLEVELAND, OH
07.2011 - Current
- Ensured accuracy and payer compliance of claim submissions.
- Tracked reimbursement requests through internal systems and follow-up queues.
- Communicated with payers about claim status, denials, and documentation needs.
- Resolved reimbursement issues with finance, coding, and customer service teams.
- Prepared supporting documents for appeals and reprocessing requests.
- Researched rejections, investigated problems to appeal claims.
- Advised supervisors and clinicians of billing deficiencies to support charge capture.
- Evaluated patient accounts to establish appropriate reimbursement amounts based on insurance coverage.
- Provided guidance on proper coding techniques according to ICD-10 guidelines.
- Analyzed medical records to ensure accuracy of coding and billing information.
- Reviewed Cleveland Clinic charts for ICD-10, CPT, and HCPCS coding accuracy.
- Analyzed denials from insurance companies and created reports detailing root causes to improve future submissions.
- Submitted electronic and paper claims to insurance companies within established timelines.
- Maintained accurate records of all reimbursements processed in compliance with HIPAA regulations.
- Attended seminars to remain up-to-date with coding guidelines and reimbursement requirements.
REVENUE CYCLE MANAGER
THE MEDINA SURGERY CENTER
MEDINA, OHIO
01.2005 - 10.2010
- Managed revenue cycle operations for Medina surgery center patient accounts.
- Oversaw complete lifecycle of revenue operations.
- Monitored daily cash flow activity, ensuring timely filing of claims and proper reimbursement for services rendered.
- Reviewed claims for accuracy using billing and coding guidelines.
- Tracked denials and corrected claim issues with payers.
- Collaborated with clinical and billing teams to resolve reimbursement issues.
- Monitored accounts receivable and followed up on outstanding balances.
- Posted payments and adjusted accounts in practice management systems.
- Coordinated patient registration and demographic updates for surgical services.
PATIENT ACCESS SPECIALIST
METROHEALTH MEDICAL CENTER
CLEVELAND , OHIO
02.1999 - 11.2005
- Registered MetroHealth Medical Center patients, verifying demographics and insurance details.
- Verified patient insurance coverage, collected copays and other payments, processed credit card transactions.
- Explained registration requirements and financial policies to patients and families.
- Resolved eligibility and coverage questions with insurers and internal MetroHealth teams.
- Updated medical records and corrected account information for accurate patient access.
- Supported front desk operations and maintained confidential patient information at MetroHealth Medical Center.
- Applied HIPAA privacy and security regulations while handling patient information.
- Performed data entry tasks associated with registrations such as entering demographic data into system database.
- Obtained necessary signatures for privacy laws and consent for treatment.
- Demonstrated knowledge of coding systems used in healthcare setting for reimbursement purposes.
Education
High School Diploma -
WOOSTER BUSINESS COLLEGE
Cleveland, OH06-1998
High School Diploma -
NORTH ROYALTON HIGH SCHOOL
North Royalton, OH05-1987
Skills
- ICD-10 coding
- CPT coding
- HCPCS coding
- Procedural coding
- Claims adjudication
- Denial management
- Denial appeals
- Appeals handling
- Medical billing experience
- Revenue cycle management
- Knowledgeable in EPIC
- Problem solving
- Detail orientation
Certification
- CERTIFIED PROFESSIONAL CODER- CPC
Timeline
Coding and Reimbursement Specialist
THE CLEVELAND CLINIC
07.2011 - Current
REVENUE CYCLE MANAGER
THE MEDINA SURGERY CENTER
01.2005 - 10.2010
PATIENT ACCESS SPECIALIST
METROHEALTH MEDICAL CENTER
02.1999 - 11.2005
High School Diploma -
WOOSTER BUSINESS COLLEGE
High School Diploma -
NORTH ROYALTON HIGH SCHOOL