Beverly Frentress

P: 225-***-**** E: ady8tx@r.postjobfree.com

SUMMARY

Claims processing professional with over thirty-seven years of experience working in Medicaid accounts. Combines industry knowledge with management experience, process analysis/improvement and leadership to create efficiency and cost savings while still providing excellent service to the client and vendors. Excels at cultivating and maintaining an excellent rapport with vendors and clients and taking on new challenges. Excellent presentation skills and experience conducting training.

SKILLS & EXPERTISE

• Management • Trainer/Teaching • Healthcare Claims Processing • Continuous Improvement • Communication • Leadership • Organizational Skills • Teamwork • Strong Work Ethic • Integrity • Critical Thinking • Attention to Detail • Presentation Skills • Computer Skills (Microsoft Office) • Time Management • Problem Solving

E X P E R I E N C E

Gainwell Technologies Baton Rouge, LA

Claims Processing Manager 2020 – present

Continued in my role as claims processing manager after the DXC healthcare business was sold and became Gainwell Technologies to ensure uninterrupted processing of Medicaid claims. Manage a staff of thirteen employees within the mailroom, claims screening, scanning, Medicare/Medicaid crossover, data entry, and files maintenance.

Continuous review of processes for new methods to increase efficiency and/or cost savings. Most recently, with the support of upper management and systems, a new method to process claims was implemented. The results were a large reduction in claims being returned to providers, reduced postage costs, and labor while providing more detail regarding incorrect claims.

Partner with systems team to implement efficiencies within department functions.

Ensure the department is meeting all contract compliance points

Represent Gainwell in client/vendor meetings related to claims processing.

DXC Technology Baton Rouge, LA

Claims Processing Manager 2018 – 2020

Continued in my role as claims processing manager after DXC acquired Molina Medicaid Solutions to ensure uninterrupted processing of Medicaid claims. Manage a staff of seventeen employees within the mailroom, claims screening, scanning, Medicare/Medicaid crossover, data entry and files maintenance.

Continuous review of processes for new methods to increase efficiency and/or cost savings.

Partner with systems team to implement efficiencies within department functions.

Ensure the department is meeting all contract compliance points

Successfully reduced the cost of the courier vehicle by 50% working with DXC to qualify for their lease program rather than paying a monthly long-term lease.

Represent DXC in client/vendor meetings related to claims processing.

Molina Healthcare – Molina Medicaid Solutions Baton Rouge, LA

Claims Processing Manager 2010 – 2018

Continued in my role as claims processing manager after Molina acquired Unisys Medicaid to ensure uninterrupted processing of Medicaid claims. Managed the mailroom, claims screening, scanning, Medicare/Medicaid crossover, data entry and files maintenance while working to upgrade old, inefficient equipment and processes.

Spearheaded the partnership with our data entry vendor to replace our aged system resulting in the development of a new customized, web-based data entry system at a lower cost that competitors presented.

Successfully obtained project management’s approval to close PO Boxes after a reduction in fee-for-service claims due to a state Managed Care initiative thus allowing savings on rental fees and caller service fees.

Accepted a proposal from our mailing vendor to allow them to process all our mail flats resulting in a postage savings of over $5000 per year from 2013-2018, at which time changes to postal regulations eliminated the savings.

Successfully presented a proposal to purchase software allowing a mail meter to be connected to the folder/inserter making the folding, inserting, and metering a seamless process saving time and labor.

Successfully presented a cost analysis to purchase an onsite folder/inserter to handle large client mailings rather than using an outside vendor. The ensuing cost savings paid for the equipment within 18 months of use.

Unisys Corporation Baton Rouge, LA

Claims Processing Manager 2007 – 2010

Quality/Contract Compliance Manger 1991 – 2007

After serving as the contract compliance manager performing a variety of roles, I began my role as claims processing manager on the Louisiana Medicaid account. Managed the mailroom, claims screening, scanning, Medicare/Medicaid crossover, data entry, and files maintenance while working to upgrade old, inefficient equipment and processes.

Spearheaded the replacement of old, inefficient scanning equipment which increased production of claims and reduced turnaround time.

Successfully obtained project management’s approval to replace outdated, unreliable postage meters with newer equipment which provided package tracking software, newer ink cartridge technology to save ink and more efficient, accurate processing of metered mail.

Effectively coordinated the SOC1 and contract compliance audits ensuring there were no findings to report while developing a rapport with the audit firm

Oversaw the online documentation project to ensure its success and worked closely with the systems team to design and develop a website for the client

Assisted in the proposal development of a successful rebid for the contract

Facilitated developmental training to all site personnel

Unisys Corporation Oklahoma City, OK

Quality Analyst 1989 – 1991

Provider Relations Field Representative 1987 – 1989

Data Entry Supervisor 1985 – 1987

Coordinated and monitored all quality control and claims processing assessments for CMS audits

Served as liaison to the Department of Human Services on all quality related issues

Hired data entry staff, conducted data entry training, established unit procedures, and wrote the desk level procedure manual

Worked closely with other departments and the client to ensure a successful implementation

Facilitated developmental training to all site personnel

Conducted statewide training seminars as well as traveling to provider locations to assist with claims payment

Previous experience as Manager of Canadian Operations for Information Retrieval Methods in Dallas, TX (1983).

E D U C A T I O N

Baylor University – SCHOOL OF Education Waco, TX

Bachelor of Science, Elementary Education

Honors & Activities: Dean’s List / Mortar Board grant recipient

McLennan Community College – Waco, TX

Honors & Activities: Dean’s List / Phi Theta Kappa

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