Enrollment Eligibility Primary Care
Resume:
Betrese Renfro
*************@*****.***
SUMMARY
Hardworking, dedicated and organized individual with extensive experience in handling complex issues
and working under pressured settings. Major strengths in customer focus, excellent communication and
organizational skills with a significant desire for perfection.
BUSINESS EXPERIENCE
Evolent Healthcare
Chicago, IL
Supervisor of Enrollment/Eligibility June 2020 – July 2023
Contribute to process workflow discussions and help set expectations on daily individual contributions to ensure an equitable processing environment exists across the team. Ability to assist in small cross-training and provide feedback as appropriate for follow up to ensure process compliance and minimum production targets, per person, are met. Possess or develop through goal planning, an end-to-end comprehension of the Eligibility and Enrollment
Billing/Eligibility Analyst March 2018 – June 2020
Work closely with claims department. Adjust premiums and rates for financial billing. Oversaw the task of sending invoices to healthcare vendors and monitoring outstanding balances to ensure accurate billing information. Review and update members eligibility and insurance in Aldera system. Identified, researched and resolved billing variances to maintain accurate eligibility.
Enrollment/Eligibility Specialist March 2016 – March 2018
Enter eligibility and/or enrollment data into Aldera system on a daily basis including new enrollees,
change in circumstance terminations, Primary Care Physicians, and brokers information. Review Daily
834 files during the Aldera system load process. Research and work any discrepancies or errors.
Fresenius Medical Care September 2013- March 2016
Westchester, IL
Insurance Billing/ Verification
Verify and document patient insurance information provided to the billing group. Adjust premiums and
rates for billing and generate the reports on a daily/monthly basis. Contribute to the timely and accurate
processing of the account receivable billing and collections functions by ensuring all patients insurance
are up to date an accurate. Work directly with clinic, regional and divisional staff to resolve identified
issues.
ADP Dealer Services September 2010 – September 2013
Hoffman Estates, IL
Payroll Consultant
Manage and maintain payroll processing schedules on behalf of client organizations. Performed
required task and steps to ensure production of timely and accurate employee payments, transfer of
funds (EFT) and delivery of appropriate reports and related files for assigned clients. Monitor and report
on payroll performance metrics related to assigned clients.
EDUCATION
College of Office Technology March 2001 - December 2001
Mirco Computer / Business Administration
Received Certificate
SPECIAL SKILLS
Excellent written and verbal communication skills. Microsoft (including Excel and VLOOKUPs)
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