Anna Fox, Mpa, Acc Email & Phone Number

Baton Rouge, La, Us

Baton Rouge, Louisiana, United States

Directs a staff of eight Program Monitors (Training Facilitators) involved in training all phases of mandated and competitive training programs for all LDH staff state wide. Oversight of state wide training programs include relevant state and federal rules/regulations, training program development, implementation, appropriate application and monitoring. Directs, develops, and implements policies, procedures and long and short-range goals relative to the rules, regulations, policies, and procedures that govern the identified training programs. Organizes scheduling assignments and identities staff development needs. Directs and approves the development, revision, and submittal of all program documents, notifications, and reports required by executive management. Assist LDH leadership, section heads, and our partnering healthcare industry to establish strategic policy for programmatic initiatives, incorporating best practices from the social service/healthcare community. Make decisions and recommendations in the areas of knowledge transfer that have department-wide impacts on the LDH mission. Accomplishments: LDH Leadership Training Academy - Developed program structure for a 3-tier leadership training program including the following components: participant eligibility criteria, selection process for program offices, program course schedules, facilitator assignments, executive coaching program and leadership mentor program. LDH – EET Ntrinsx Training – Coordinated department wide assessment and training for Ntrisnx – Understanding People. Created facilitator training team assignments and worked directly with program office leadership to create staff training schedules for all program office staff. Monitored training outcomes and staff satisfaction with training content and facilitators.

Baton Rouge, Louisiana, United States

• Project owner for upgrade of DOC pharmacy management software and implementation of new eMAR program at all eight state prisons with an average of over 62,000 active prescriptions. Serves as the database administrator for eMAR and works with vendor to configure program to meet LADOC requirements, and preforms testing and reports issues to vendor for program updates.• Worked closely with the state prisons to document current pill call operations and created written workflows for each unit within all eight state prisons. Created training programs used for initial implementation and continuing staff education. • Serves as member of DOC EHR team with primary responsibilities focused on medical staff training and technical assistance.

Baton Rouge, Louisiana Area

State Targeted Opioid Response Initiative Grant – Contract Position• Oversees administrative program functions including program data management, clinician supervision, data compliance program, and data quality assurance program.• Created and maintains program database used to generate reports for DOC leadership and Louisiana Department of Health.• Investigates discrepancies in clinician reports and other DOC databases to ensure accuracy of participant data.• Conducts monthly site-visits to ensure clinician compliance with program curriculum and record keeping requirements.

Baton Rouge, Louisiana Area

• Managed the Revenue Cycle Department for an FQHC with multiple service lines including medical, behavioral health, and dental.• Negotiated and maintained medical, behavioral health, and dental network agreements for providers and facility with multiple managed care organizations with special focus on Medicare and Medicaid MCOs.• Created provider and facility credentialing program in accordance with HRSA Community Health Center guidelines, and maintained provider CAQH, NPPES, and PECOS files. Conducted onboarding of all new clinical providers/staff to include verification of education; clinical training; licensure; and sanction checks through NPDB, OIG, and SAM.• Responsible for direct supervision of department staff to include hiring, training, evaluation, and counseling.• Monitored billing and coding staff workflows and performance to ensure timely and accurate filing and collections of all claims in Athena and Dentrix EHR systems.• Served as a member of the organizations Clinic Quality Committee responsible for presenting provider credentialing files and status of clinic revenue.

Baton Rouge, Louisiana Area

• Lead a team of eight Credentialing Specialists that conducted initial credentialing, reappointment, and Managed Care credentialing for a large multi-specialty group of 440 physician and mid-level providers including initial credentialing and maintenance of provider network records.• Successfully negotiated credentialing delegation agreements with multiple managed care organizations by demonstrating that the CVO credentialing policies and processes met NCQA and URAC guidelines.• Responsible for the credentialing compliance and auditing programs to ensure adherence to federal and state regulations; NCQA and URAC guidelines; and MCO delegation agreements.• Served as an administrator of APOGEE Managed Care credentialing database and was a member of the CVO project team that was working toward streamlining the Managed Care credentialing process across the health system and obtaining NCQA CVO certification.• Restructured the payer enrollment team and process for initial provider enrollment with non-delegated MCOs that resulted in a reduction in the time needed to complete credentialing and provider linkage with group contracts.

Olol Physician Group - Recruiting & Business Development

• Conducted initial enrollment and re-credentialing for a multi-specialty practice of 440 physician and mid-level providers with Medicare, LA and MS Medicaid, and various Medicare and Medicaid managed care organizations.• Responsible for the Medicare and Medicaid compliance program including updating management on changes to regulations, and preparing training materials and presentation to the credentialing team.• Corrected non-compliance with provisions of the Affordable Care Act by creating a process to ensure that providers not enrolled as billing providers were enrolled as ordering/referring/prescribing providers for Medicare and Medicaid.

• Provided guidance and oversight to three Licensing Analyst I and one Administrative Coordinator regarding board rules and departmental procedures including conducting departmental compliance audits to ensure applicants were processed in accordance with LAC Title 46:XLVII, Subpart 2 - Professional and Occupational Standards-Registered Nurses, and the National Council of State Boards of Nursing guidelines.• Reviewed and processed complex applications for candidates with criminal, mental health, and/or addiction history to determine if candidate met requirements for licensure in Louisiana and referred cases to investigations or hearings department when necessary.• Redesigned workflow of department and created desk procedures to allow for efficient processing of annual departmental caseload of 6000 clinical and licensure applications.• Eliminated need for one full time administrative support position after implementation of new process and reduced departmental supply costs by restructuring departmental records system.• Created policy to ensure compliance with the Americans with Disabilities Act (ADA) when assessing and granting requests for special testing accommodation on licensing examinations.

Completed one - year assignment at Pinnacle Business Solutions, Medicare Part B Carrier for Louisiana and Arkansas as a Provider Enrollment Specialist.• Assignment focused on recertification of over 4000 individual and group providers in Louisiana and Arkansas and initial provider setup in PECOS.• Functioned as team - lead over seven other enrollment specialists to ensure that workload were evenly distributed and that the applications were being processed in a timely manner.• Consistently a top producer for number and accuracy level of applications processed each month.

• Conducted research to ensure compliance of home health / hospice billing software with federal and state regulations, and composed written documentation to advise product management and development teams of required changes to ensure continued compliance.• Reviewed and formulated organizational response to RFPs for changes to CMS regulations or state Medicaid regulations for over 20 state Medicaid programs.• Advised technical writers in creation of documentation for both internal departments and customers that included explanation of regulatory changes.• Project lead for implementation of National Provider Identifier (NPI) within product and worked with clients to ensure all clients had applied and/or obtained NPI prior to CMS implementation deadline.• Created processes for clients when federal and/or state mandates required changes that could not be accomplished by modification to billing software.

San Antonio, Texas Area

• Managed corporate billing and collections office for a DME company with offices in Texas and Louisiana, with annual billings of $6.5 million.• Responsible for all HR functions including hiring, training, evaluation, counseling, and payroll for corporate office staff.• Administrator of compliance program for corporate and field office staff including updating policies and conducting staff training for changes to Medicare and Medicaid requirements.• Created quality review program for field office and billing staff that resulted in significant reduction in claim denials.• Worked with Medicaid HMO to correct claims processing error, which resulted in back payment of almost $1 million of denied claims.• Prepared and presented complex Medicare appeals with special focus on Fair Hearings and Administrative Law Judge cases as well as advising special collection teams focused on high volume managed care collections.

Master'S Degree, Public Administration And Healthcare Administration

Activities and Societies: Phi Kappa Phi Pi Alpha Alpha Honor Society Member Phi Kappa Phi & Pi Alpha Alpha Honor Society

Bachelor Of Science In Human Services, Child And Family Welfare