Directer Of Enrollment And Billing / Operations Analyst/ Team Leader / Developer
Managed design, implementation and reconciliation of Qualified Health Plan and Essential Plan enrollment and billing. Designed and implemented reconciliation processes for Medicaid and Child Health Plus(CHP) enrollment and billing from sales through payment. Designed and implemented processes to recover more than $10M in missed Medicaid and CHP payments. Designed and managed newborn kick billing and Health Home billing processes. Responsible for designing implementation of Facets for Membership, Application Work Flow, Member Recertification process, Quality Improvement, and CHP KIDS interfaces. Managed a Team of Programmers and Business Analysts that supported the business processes of two Corporate Divisions. Design and develop systems for Recertification tracking, Membership Roster analysis, Dual Enrollment analysis and processing, and Billing and Remittance reports using Visual FoxPro 6.0 and 7.0 and Visual Studio.NET. Designed and implemented corporate intranet using SharePoint Services being used by Finance, Membership and Public Affairs. Introduced MapPoint as an analysis tool, used by several departments to better understand data.