Barbara Barrows Email & Phone Number

Boston, MA, US

Boston, MA, US

Serves as the chief liaison between OLTSS and various systems and IT functions within EOHHS. Leads projects and audits that are primarily systems/technical focused using appropriate software development lifecycle (SDLC) methodology and other current IT project management industry standards. Serves as the lead technical subject matter expert (SME) for all.

• Assists in the coordination, implementation and monitoring of provider requirements for MassHealth initiatives
• Oversight and coordination of provider education and communication activities with stakeholders and vendors
• Oversight of provider file integrity review and liaison activities with CMS
• Serve as part of vendor contract review and procurement as needed
• Serve as Provider Operations liaison assisting MassHealth Program Staff and Provider Operations Staff with day-to day business operations, escalated provider issues and working with vendor to find operational resolutions

• Oversaw, monitored, and evaluated program activities for the Personal Care Attendant (PCA) and Early Intervention (EI) programs, reporting to manager and senior staff on program management activities
• Advised on issues related to the impact of proposed legislation as well as any issues raised by federal oversight agencies
• Promoted and established collaborative, working relationships with internal and external stakeholders, including contracted entities and other state and federal agencies
• Interfaced with Provider Compliance Unit to oversee and identify areas for improvement in established processes to avoid fraud, waste and abuse
• Collaborated with the Attorney General's Bureau of Special Investigations to refer and follow up on individual cases, reflecting on observations and findings to develop ways to strengthen program integrity within the.

Houston, Texas, US

• Responsible for the daily aspects of operating the provider outreach and communication team and ensured smooth functioning of the unit
• Oversaw and trained team in areas of strategic deployment of training and provider communication
• Utilized survey tools as a way of evaluating training effectiveness and reporting
• As part of the leadership team, supported the unit in the application of budgets, the internal development of staff and the coordination of management events
• Coordinated and delivered quarterly executive level training with provider association representatives and Executive Office of Health and Human Services (EOHHS) staff
• Worked with EOHHS managers and special work groups and committees in the implementation of publications and policies

Houston, Texas, US

• Managed and delivered all communications between MassHealth and multiple provider-specific professional associations
• Provided daily outreach and support to Massachusetts medical providers in areas of provider enrollment, medical claims submissions and medical claims resolution
• Developed and delivered educational programs, including new provider training, billing software training and program specific training
• Served as subject matter expert for MassHealth’s Provider Online Service Center (POSC) and Medicaid Management Information System (MMIS) both internally and with provider community
• Partnered with EOHHS and HP staff to develop and manage the implementation of programmatic and regulatory changes.
• Provided weekly analysis of EOHHS reports for purposes of identifying system issues

New York, NY, US

• Worked independently and as part of a team in the establishment and refinement of reimbursement methodologies for various healthcare providers, such as hospitals, long-term care facilities, and ambulatory surgery centers
• Recommended and supported reimbursement strategy refinements in line with industry trends and network development goals
• Responded to inquiries from internal and external clients with regard to the various contract support systems and claims pricing systems. Provided training to field staff on new and revised methodologies and software

Boston, MA, US

• Scheduled, prepared sensitive medical record information, and responded to all third party audits
• Oriented all auditors to hospital audit procedures, conducted exit interviews with auditors, and reviewed discrepancies
• Analyzed discrepancies cited by the auditor, wrote rebuttal to auditing firm, logged audit, and reported trends

• Reviewed non-clinical provider appeals and recorded outcome into the Access database
• Created cost savings reports using system downloads and various databases via queries

Canton, Massachusetts, US

Held several postions in medical claims, reporting and reimbursement departments.

Canton, Massachusetts, US

• Was responsible for creating fee schedules and cost impact analysis for the region
• Researched Medicare fees and policies and correspondence for analysis
• Resolved claims payment issues regarding fee schedules
• Reviewed hospital contracts and submitted vendor pages to configuration for implementation

• Trained new Claims Examiners and was responsible for the daily aspects of operating the claims production for the teams and ensured smooth functioning of the unit
• Prepared reports and submit proposals to supervisor/manager regarding workflow

• Provided informational and technical support to the Claims Examiners, Member Advisors, Internal Departments and Providers

• Ensured payment of authorized claims for eligible members for covered benefits to contractual and non-contractual providers within an agreed upon time frame
• Responded to telephone inquires from members and providers regarding issues

Bachelors Of Arts In Business With Focus On Public Administration

As, Health Administration Mgmt

Education record

Mathematics

High School, College Prep

Nursing