Carol Berry, Csfs

Carol Berry, Csfs Email and Phone Number

Chief Executive Officer at Health Care Administrators Association @
Carol Berry, Csfs's Location
Los Angeles County, California, United States, United States
Carol Berry, Csfs's Contact Details

Carol Berry, Csfs work email

Carol Berry, Csfs personal email

n/a
About Carol Berry, Csfs

In her position as HCAA CEO, Berry is responsible for the promotion of third-party administrators (TPAs) and others within the self-funding industry, as well as driving implementation strategies to achieve HCAA’s short- and long-term strategic initiatives. With guidance from the Board of Directors, she extends awareness of self-funding, promotes educational forums, engages and grows membership, and directs advocacy efforts.She is responsible for supporting the efforts of HCAA’s Board to maintain and enhance current relationships with sister organizations and for creating new relationships, that bring value to HCAA. She also provides strategic direction for HCAA's association management company. Ms. Berry reports to HCAA’s Executive Board.Ms. Berry has extensive experience in the health care and software industries providing corporate leadership, operations consulting, product positioning and strategic planning. She has held successful executive positions in self funding, managed care, managed behavioral health, and group medical insurance companies. She served as HCAA’s President 2001-2002 and was awarded the HCAA designation of a Certified Self Funding Specialist® (CSFS®) in July, 2009. Specialties: Self Funding, Healthcare, Insurance, Claims, Benefit Administration, Strategy, Operations, Contracts, Networks, Information Technology

Carol Berry, Csfs's Current Company Details
Health Care Administrators Association

Health Care Administrators Association

Chief Executive Officer at Health Care Administrators Association
Carol Berry, Csfs Work Experience Details
  • Health Care Administrators Association
    Chief Executive Officer
    Health Care Administrators Association Sep 2014 - Present
    In her position as HCAA CEO, Ms. Berry is responsible for the promotion of third-party administrators (TPAs) and other affiliated members within the self-funding industry, as well as driving implementation strategies to achieve HCAA’s short- and long-term strategic initiatives. With guidance from the Board of Directors, she extends awareness of self-funding, promotes educational forums, engages and grows membership, and directs advocacy efforts. She is responsible for supporting the efforts of HCAA’s Board to maintain and enhance current relationships with other industry organizations and for creating new relationships, that bring value to HCAA. Ms. Berry reports to the HCAA Board’s Executive Committee.
  • Health Care Administrators Association
    Chief Operating Officer
    Health Care Administrators Association Aug 2011 - Sep 2014
    The COO is responsible for maintaining and enhancing professional relationships with HCAA members, the Board, members of other Associations, government officials and the media, at the direction of the Board. She is skilled at business development and is an excellent marketer of HCAA and its products. The COO provides strategic direction to the Association management staff and is responsible for managing its contract. She is responsible, at the direction of Board, for raising the awareness of TPAs as an important quality alternative for health care administration and for increasing the awareness of HCAA as a leading organization in the healthcare industry.
  • Lockhurst Consulting
    Principal
    Lockhurst Consulting Jan 2008 - Aug 2011
    Expanded consulting practice to support a wide range of health care entities, both self funded TPA and managed care, assisted them in developing operational efficiencies, increasing market share, optimizing internal work flows, upgrading reporting, identifying and providiing solutions for web site and system improvements and expanding client services. Performed market surveys, market analyses, held strategic planning sessions, performed operational reviews, developed policy and procedure manuals and worked with brokers, clients, networks and provider offices on installations of web browsers to increase connectivity and service at the client and provider office levels.
  • Hcaa
    Board Director
    Hcaa 1998 - Aug 2011
    President 2001-2002Board Director 1998 to 2011Education Committee Chairman 2005-2011Public Relations Committee Chairman 2010-2011Certified Self Funding Specialist 2009-Present
  • Coastal Tpa
    Consultant
    Coastal Tpa Apr 2009 - Jul 2011
    Responsible for a wide range of consulting activities for the TPA - assisting in developing operational efficiencies, increasing market share, optimizing internal work flows, upgrading reporting, reviewing their web presence, identifying system improvements, managing their vendor relationships and expanding their client services. Performed market surveys, market analyses, held strategic planning sessions, performed operational reviews, developed policy and procedure manuals and worked with brokers, clients, networks, system vendors and provider offices on the use of the web to increase connectivity and service efficiencies. Provided support to partially self funded employer clients and their broker/consultants for PBM implementations, excess loss vendor changes, oversight on TPL subrogations, work on ERRP & RDS filings, IRO selections and scheduled member notifications to comply with all Federal and PPACA requirements. Assisted in plan document development, client communications, client implementations and de-implementations and worked with MGUs, actuaries and carriers to service clients.
  • Pcg Software
    President
    Pcg Software 2006 - Dec 2007
    PCG software is a small, privately held company that offers a suite of software solutions that identifies claims fraud and abuse, provides cost containment solutions and identifies opportunities for financial recoveries for both payer and provider healthcare organizations. Brought in to change corporate direction and to provide strategic planning, development of strategic relationships, corporate branding, corporate leadership, business development and new Internet product development.
  • Healthlogic Systems Corporation
    Senior Vice President
    Healthlogic Systems Corporation Jul 2004 - Aug 2006
    HealthLogic provided an industry-leading electronic claims attachment solution (CADX) for payers and providers. Responsible for strategic planning for all sales and marketing efforts nationwide and constructed product training programs for all users. Developed detailed implementation processes and assisted clients in designing internal workflow changes to optimize use of CADX. Developed and designed user training materials and guides. Worked with programming personnel to design modifications and upgrades to CADX to optimize the product and to facilitate and increase user satisfaction. Assisted in working with CADX’s twenty national hospital clients to utilize the products to enhance their revenue cycles and to increase their EDI percentages.
  • Hospital Assoc. Of Southern California
    Senior Vice President
    Hospital Assoc. Of Southern California Apr 2002 - Jun 2004
    Claim Recoveries Unlimited (CRU) was a division of AllHealth, the business services subsidiary of the Hospital Association of Southern California. CRU supported physician groups in the recovery of managed care revenue from health plans and assisted capitated physician groups to recover overpayments. Developed the business plan, developed and executed sales and marketing strategies to bring the business to market, hired staff, oversaw day-to-day operations and assisted in workflow development to recover funds for physician groups by review and audit of claims payments.
  • Insurance Claims And Compliance Consultant
    Consultant
    Insurance Claims And Compliance Consultant Jan 2001 - Apr 2002
    Provided expert witness and consulting services to litigation attorneys on health insurance contract analysis, investigations of “bad faith” actions, health insurance coverage analysis, health insurance claims customs and practices, and on managed care claims customs and practices. Served as an on-site manager and compliance auditor/consultant for Maxicare Health Plans of California. Provided training in claims processing, inventory, policies and procedures, communications development and timeliness reports filling for Maxicare providers. Additionally provided consulting services on managed care operations and marketing.
  • Vertihealth Administrators
    President
    Vertihealth Administrators Oct 1993 - Dec 2000
    VertiHealth, a subsidiary of UNIHEALTH, with a staff of one hundred, was an administrative services support vendor that marketed to nationwide managed care organizations and provided claims, medical management, consulting and capitation management support services. Developed national sales and marketing efforts targeted toward Hospitals, Physician Groups, MSO’s, and HMO’s and also developed its national consulting business. Negotiated and sold contracts to perform capitation readiness audits, operations review, HCFA audits, consulted with developing HMO’s and provided operational consulting to managed care organizations. Developed strategic plans for growth and supervised technology acquisitions and development.
  • Managed Health Network
    Director
    Managed Health Network 1990 - 1993
    Regional office liaison, product development, marketing and proposal writing responsibilities. Designated as the Account Manager for Nordstrom. Designed internal operational and administrative procedures to support product lines, answered requests for proposal and developed Sales/Marketing training programs. Responsibility for Claims, Management Information Systems and Provider Information Center, with a staff of forty-five. Focus was on productivity and quality enhancement, hiring and terminating, developing policies, procedures and standards, adding software and hardware, developing training and internal audit functions.
  • Wellpoint
    Director System For Managed Care
    Wellpoint Jan 1989 - Dec 1989
    Indianapolis, Indiana, Us
    Responsibility for a staff of eleven business analysts, tester-auditors, and support personnel which analyzed systems, interviewed users, and developed business requirements for software enhancements to the Major Accounts System. Headed the development staff for “System for Managed Care”, an alternative fully integrated interactive software designed to consolidate all Blue Cross claims processing into one new integrated software.
  • Equicor
    Regional Director
    Equicor 1985 - 1988
    Acted as liaison officer between the Western Regional Service Center and twelve regional managed sites. Provided daily interface with health plan managers and marketing directors on operational issues and growth support. Provided employer and physician contract review for systems supportability and financial advantage. Managed regional claims and eligibility input personnel. Developed regional policies and procedures. Coordinated the communication of employee benefits and administered insurance and tuition reimbursement programs. Supervised cases in litigation and cases involving reinsurance. Developed system software enhancements including capitation conversion enhancements, processing aids, and on-line letter writing and worked with consultants to develop capitation programs to fit market and plan needs.

Carol Berry, Csfs Skills

Health Insurance Strategic Planning Managed Care Employee Benefits Insurance Leadership Healthcare Management Medicare Health Policy Claim Benefits Administration Training Executive Management Healthcare Consulting Policy Long Term Care Healthcare Information Technology Healthcare Industry Hipaa Physicians Medicaid Provider Relations Workers Compensation Hmo Claims Management Brokers Underwriting Ehr Medical Billing Healthcare Management Disease Management Reinsurance Pharmacy Benefit Management Disability Insurance Life Insurance Ppo Utilization Management Litigation Subrogation Claims Benefit Administration Pbm Health Plans Insurance Claims Disputes Medical Management Group Benefits Group Health Dispute

Carol Berry, Csfs Education Details

  • Washington State University
    Washington State University
    Political Science

Frequently Asked Questions about Carol Berry, Csfs

What company does Carol Berry, Csfs work for?

Carol Berry, Csfs works for Health Care Administrators Association

What is Carol Berry, Csfs's role at the current company?

Carol Berry, Csfs's current role is Chief Executive Officer at Health Care Administrators Association.

What is Carol Berry, Csfs's email address?

Carol Berry, Csfs's email address is cb****@****caa.org

What schools did Carol Berry, Csfs attend?

Carol Berry, Csfs attended Washington State University.

What are some of Carol Berry, Csfs's interests?

Carol Berry, Csfs has interest in Claims, Information Technology, Project Management, Strategic Planning, Operational Efficiency.

What skills is Carol Berry, Csfs known for?

Carol Berry, Csfs has skills like Health Insurance, Strategic Planning, Managed Care, Employee Benefits, Insurance, Leadership, Healthcare, Management, Medicare, Health Policy, Claim, Benefits Administration.

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