Wendy Bishop-Barber Email & Phone Number

Baton Rouge, La, Us

Baton Rouge, Louisiana, United States

Federal laws enforced by the Centers for Medicare and Medicaid Services (CMS), including the Affordable Care Act and the 21st Century Cures Act, require states to screen and enroll all providers. Within in this job role, my responsibility is to oversee design creation, implementation and maintenance of Louisiana Medicaid’s web-based provider enrollment portal tool.• Manage and monitor Louisiana Medicaid provider enrollment contracted vendor deliverables.• Contribute to security designs through acquisitions and/or system developments to deliver and maintain a compliant system ensuring provider enrollment operations and procedures meet government and state compliance standards.• Manage provider enrollment team resources and workflow to reach maximum efficiency and productivity levels.• Assess policy and system procedures developing streamline and systematic enhancements.• Lead, manage, and guide provider enrollment specialists to exercise initiative and judgment in applying established principles and practices to new and unusual issues and problems; direct overall goals and objectives.• Monitor, test and track web-based provider portal interface system functionality, identifying inaccuracies and system limitations.• Analyze provider enrollment system data by extracting, creating reports, pivot tables, charts, graphs and workflows.• Work closely with Managed Care Organizations (MCO), Hospitals Associations and Healthcare Systems developing outreach initiatives, to assure providers are enrolled through the web-based portal.• Create quality assurance program for Fee for Service (FFS) and web-based portal providers enrollment applications, ensuring the contractor is executing enrollment process in accordance with CMS and state Medicaid guidelines.• Develop and maintain relationships with internal, external contacts and stakeholders communicating effectively to translate compliance requirements.

Baton Rouge, Louisiana, United States

Managed statewide Medicaid Eligibility Customer Service Center, Support and Mail Processing Operations staff; 300+ direct and indirect staff, servicing 1.5 million members. Transitioned call center operations in-house improving member experience, staff satisfaction and an annual state cost savings of 24 million dollars. • Managed and monitored call center call contractor deliverables, service level agreements and assessed penalties until transitioned back in-house. • Extracted call data, creating call center reports, graphs and charts to monitor and ensure federal and state mandated standards, including Average Speed to Answer (ASA), Abandonment Rate and Average Handle Time (AHT).• Analyzed historical and current call data, identifying trends and forecasting call volumes; adjusted and maintained adequate call agent scheduling, resourcing and recruitment initiatives to achieve service level targets and business need.• Calculated and optimized call center performance and productivity through data analysis, monitoring and reporting metric results daily, monthly and quarterly to senior management.• Created a Quality Audit program monitoring and scoring agent calls to improve service delivery, minimize errors, and insure federal and state Medicaid policy is accurately communicated to customers.• Developed and implemented call center platform enhancements, decreasing AHT and agent error rates. • Maintain consistent professional improvement through company provided workshops, tracking call center trends and active participation in team focus groups and projects.• Created and maintained customer call center tip guides, user manuals and procedures.• Reviewed and analyzes complex data and system reports to ensure compliance with program regulations. • Administered the day-to-day operational functions of the Medicaid fee for service programs. Assures that program policy and procedures are properly applying in accordance with federal and state laws and regulations.

Baton Rouge, Louisiana Area

Managed day-to-day network operations consisting of 35 direct and indirect reports in areas including Intake, Provider File Maintenance, Credentialing, Audit and Inbound Call Unit, servicing 33,000+ practitioners and facilities. • Administered all Human Resource functions, including hiring, terminating, disciplinary action and conducting performance reviews; coached, mentored and developed team to expand career growth. Handled department budget allocation.• Developed production measures and service level agreements continuously driving productivity and quality in an inventory-based environment; managed provider enrollment and credentialing processes, continuously monitoring target dates, quality and URAC and state regulations and requirements.• Spearheaded and achieved operational process changes and improvement efficiencies, resulting to a decrease in aged inventory and process timeliness; developed action plans and set targeted goals to meet and exceed expectations. • Developed and maintained relationships with internal and external vendors, consultants and other divisions across the organization, assuring engagement to improve customer satisfaction.• Solved customer issues in a professional and timely manner; followed up with action and results.• Created and lead focus and project management teams’ division wide, collaborating and brain-storming ideas and suggestions to streamline processes among departments, building closer relationships resulting to better team alignment.• Developed project business requirements, planned, monitored and implemented corporate and departmental wide; created website forms and developed web designs for interactive customer enrollment and maintenance updates. • Created desk procedures and policies related to the network operations processes; trained and conducted side by side coaching.• Worked closely with the network development department to solicit and contract customers into the organization.

Baton Rouge, Louisiana Area

Managed day-to-day customer operations consisting of 65+ direct and indirect reports in the inbound customer call center, on-site customer service lobby and correspondence unit that processed telephonic, written and electronic inquiries, servicing 1.4 million members.• Administered all Human Resource functions, including hiring, terminating, disciplinary action and conducting performance reviews; coached, mentored and developed team to expand career growth. Handled department budget allocation.• Created, monitored and tracked production measures, both telephonic, written and electronic.• Managed turnover, scheduled adherence, quality performance, productivity and employee/customer satisfaction to ensure departmental and corporate goals were met for both provider and members.• Monitored AVAYA and Verint reports for staff forecasting and line of business needs.• Developed policies and procedures to manage service level agreements, quality assurance and timeliness to ensure compliance, consistency, effectiveness and efficiency. Trained and conducted side by side coaching related to processes.• Created project plans, assignments and communication working with IT and other departments; monitoring and meeting deliverables until execution. • Developed and implemented more modernized and efficient tools supporting external customers and internal staff members.• Resolved non-routine issues and escalations with internal and external customers.• Served on corporate committees and project management teams to design and implement customer programs, supporting initiatives and customer objectives.• Created an awards recognition program, acknowledging achievements for individual staff members and teams.

Baton Rouge, Louisiana Area

Supervised inbound call center activity, developing preventive measures to ensure effective use of resources and delivery of exceptional customer service to providers obtaining medical authorizations. Motivated and coached a team of 25 Intake Coordinators to ensure consistency and accreditation compliance.• Administered Human Resource department functions; hiring, discipline, termination and performance management.• Served as subject matter expert to staff regarding URAC standards, laws and regulations, computer systems and corporate and department policies and procedures.• Worked and collaborated with medical directors and nursing staff involving authorizations, pertaining to medical necessity.• Performed quality audits on inbound calls and written inquiries; coached staff on findings and conducted refresher training weekly regarding audit errors identified.• Established production metric expectations and drove inventory, consistently monitoring and realigning to meet targeted goals.

Baton Rouge, Louisiana, United States

Baton Rouge, Louisiana, United States

Baton Rouge, Louisiana, United States

Baton Rouge, Louisiana, United States