Compliance Officer Account Manager

Trenda A. Dewberry

*********@*****.***

Contact: 531-***-****

ORGANIZATIONAL EXPANSION ~ OPERATIONS IMPROVEMENT ~ RELATIONS MANAGEMENT

Understand complex platforms and excel in knowing my audience. A background to develop processes and structure to strengthen individual and team performance. The level of knowledge obtained over a long tenure allows me to offer detailed experience. Always striving in development roles and resources that add to an advocate, consumer, and member experience. My passion is to empower and develop individuals, add to their individual knowledge and understanding of organization goals and objectives.

CORE COMPETENCIES

Organizational Needs Assessment

Compliance Officer

Culture of Ownership

Process Oversight

Family & Meaningful Engagement

Quality Review

Problem Identification/Resolution

Research and Analysis

Training/ Motivating Personnel

Time Management/Multi-tasking

Practice Core Values

TOOLS AND TECHNOLOGY

Microsoft Office & SharePoint

Compliance Training/Oversight

Legal Corporate Compliance

New Hire Training

Provider Relations

Metric System Adherence

Power Point Presentations

Continued Education

Medical Billing

Time Management Techniques

Abide by State/ Government Regulations

Excel

Enrolment Eligibility

Indigent Program Collaboration

PROFESSIONAL HIGHLIGHTS

Business Account Manager

Consonus Long Term Care Pharmacy- July 2024 to Present

Account reconciliation for 10 long term care facilities in Nebraska.

Review pharmacy billing.

Price quotes.

Respond promptly to facility requests, orders, and resident billing.

Process resident and facility statements.

Review all statements and resolve inaccuracies

Specialty Operational Trainer/Advocate4me Sr/Subject Matter Expert

United Healthcare- June 2018 to May 2024

Virtual Operational Trainer for specialty pharmacy claims

Review pharmacy claims for multiple states; provide resolutions

Peer observation and recommendation

Enterprise workforce optimization skilling for Patient Care Coordinator and clerk

Facilitate training classes numbered up to 25 in a virtual setting

Recognized 5-year employment anniversary

Conduct learning environment with multiple systems for a 6-week period

Provide an environment of support and encouragement for learners and peers

Observe comprehension styles and develop tools using 1:1 and group session

Collaboration to revise IFP policy and procedures.

Subject Matter Expert Trainer for IFP Refresher and New Hire SME IFP Trainer

Supervisor Escalation Lead for IFP plan

Application development and testing functional requirements

2021 Service Hero Finalist

Training resource development and revisions

New hire training support 2020 and 2021

New hire coaching, quality call audits and review with TX Medicaid Instructor

August Employee of the Month 2020

Next Best Action Development Tool and Pilot

Maestro system and application Logic Pilot Committee

Exchange UES Count Highest NPS Challenge winner and luncheon

MD UES challenge week of 04/19/20 and 04/23/20

UES Champ for two supervisor teams

PROFESSIONAL EXPERIENCE

Payment Compliance/Underpayment Analyst

Parallon Business Solutions- Houston, TX – September 2017 to June 2018

Review payer contracts for accuracy, rate schedules

Customer service with clients, patients and consumers and multiple departments

Review and discuss facility charges and work with Concuity, Meditech, Etran, Erequest, Insurance Maintenance

Meet productivity and quality measurement.

Review claim forms, statements, correspondence, refunds

Courier/Independent Contractor

Lone Star Delivery and Process - Houston, TX - July 2015 to June 2017

Uphold strict timelines and instructions when delivering client information.

Delivery consists of medical supplies, patient collected specimens, legal and financial documents, building and permit plans.

Driving to multiple city and state locations and was substitute courier for 10 additional routes.

District Volunteer ALIEF School

Holub Middle School - Houston, TX - August 2014 to 2018

Student Mentor, field trip chaperone, Administrative Assistant to CISD project manager

Volunteer In public schools Family and Meaningful Engagement

Special recognition by Holub Middle School in April 2017 Luncheon

Preparation of student quarterly and annual assessment for 5th and 6th graders

Assisted with identifying resources for child development

Corporate Compliance Officer Oversight

Houston Pain Associates - Houston, TX - January 2014 to August 2014

Compliance education, updates for 20 physicians and visitation

Reviewed and updated physician credentialing and CEU file for 10 physicians.

Annual and continued training on government and state regulations.

Audits and medical record analysis to ensure quality and accuracy.

Meaningful Use, Patient Portal, PQRS measurements and Medicare credentialing

Created Patient Portal Tool

Implemented the OIG exclusions checklist into Human Resource hiring process

Education

Guthrie High School - Guthrie, OK Langston University - Langston, OK

American Intercontinental University Online Oklahoma University - Norman, OK

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