Open To Work
Tami Branch
District Heights,MD
Summary
Dynamic Insurance Authorization Specialist with extensive experience at Inova Healthcare Services. Proven expertise in prior authorization processes and compliance, coupled with strong leadership skills. Successfully managed authorization requests, enhancing reimbursement accuracy and team performance. Proficient in Epic systems, ensuring adherence to HIPAA regulations while fostering effective communication across departments.
Overview
13
13
years of professional experience
Work History
Insurance Authorization Specialist
Inova Healthcare Services
12.2019 - Current
- Managed authorization requests for medical services such as imaging (MRIs and CTs), Physical,Speech and Occupational therapies.
- Requested medical documentation to establish medical necessity, enhancing authorization accuracy.
- Collaborated with intake and billing teams to streamline handoffs, ensuring accurate reimbursements.
- Communicated with healthcare providers to clarify clinicals needed for accuracy and completeness.
- Tracked authorization statuses using electronic databases and payer portals.
- Ensured adherence to HIPAA regulations and accreditation standards (ACHC/URAC).
Clinical Evidence Assembly Supervisor
VetFed Resources
06.2018 - 12.2019
- Supervised team of 25, coaching and guiding to enhance skills and performance.
- Reviewed medical documentation and reports prior to submitting to the VA for benefit submission.
- Monitored productivity, quality metrics, and case aging.
- Coordinated workflow among team members, streamlining tasks to enhance overall efficiency.
- Ensured full compliance with HIPAA, JCAHO and confidentiality standards.
- Developed and delivered presentations to increase team accuracy and drive performance improvements.
- Led team meetings to discuss scheduling goals and address operational challenges.
Contact Center Supervisor
National Spine and Pain Centers
08.2015 - 06.2018
- Led communication department, ensuring performance standards met and maintained.
- Monitored employee performance, attendance, and conduct to support team accountability and development.
- Resolved complex, multi-faceted patient concerns efficiently and effectively.
- Maintained relationships between clinic teams and contact center, leveraging communication methods and data to enhance outcomes.
- Prepared daily, weekly and monthly KPI and productivity reports.
- Oversaw verification and authorization workflows.
- Updated training materials to ensure company compliance.
- Participated in the selection and interviewing process for potential employees.
Scheduling Coordinator
Exam One
05.2013 - 08.2015
- Coordinated insurance exam schedules while managing high call volumes to ensure timely patient access.
- Collected blood and urine specimens, maintaining detailed records for accurate patient tracking.
- Recorded patient vitals, conducted EKG tests, and collected medical histories in a clinical setting.
- Completed travel logs and supported inventory management for efficient resource allocation.
- Generated productivity reports.
Education
Associates - General Studies
University of the District of Columbia
Washington, DC05-2014
Certificate - Certified Medical Assistant
Sanz College
Washington DC11-2001
Skills
- Epic and EMR systems
- Prior authorization processes
- CPT and diagnosis coding
- Medicare and Medicaid knowledge
- CareFirst expertise
- Disco
- DMAS systems
- Passport
- Strong leadership
- Call monitoring
- Timekeeping
- Compliance
Hobbies and Interests
- Reading
- Volunteering in the community
- Baking
References
References available upon request
Work Preference
Job Search Status
Open to workWork Type
Full TimePart TimeContract WorkLocation Preference
RemoteHybridOn-SiteSalary Range
$60000/yr - $200000/yrTimeline
Insurance Authorization Specialist
Inova Healthcare Services
12.2019 - Current
Clinical Evidence Assembly Supervisor
VetFed Resources
06.2018 - 12.2019
Contact Center Supervisor
National Spine and Pain Centers
08.2015 - 06.2018
Scheduling Coordinator
Exam One
05.2013 - 08.2015
Associates - General Studies
University of the District of Columbia
Certificate - Certified Medical Assistant
Sanz College