William Bartley Email & Phone Number

United States

Responsible for developing audit, regulatory, and compliance reports and data processes.

Jessup, Pennsylvania

• Part of a small 2 Analyst, 2 Developer team responsible for CMS Compliance, Regulatory and Audit reporting.
• Lead Analyst assigned to ODAG CMS Appeals and Grievances audit reporting, Part C Reconsiderations reporting, ad hoc Federal/State reporting, and additional validation reporting requested by the client and/or business.
• Additional exposure to and experience with ODAG CMS Claims audit reporting, and ad hoc reporting related to audit data requested by the client and/or business.
• Provide technical Appeals and Grievances support throughout CMS program and validation audits
• Review regulatory guidance and technical specifications for reporting to determine technical requirements.
• Experience with delivering ad hoc claims data reports requested by the Office of Inspector General within defined SLA.

Jessup, Pennsylvania

• Performed analytical reviews for the department to ensure data integrity
• Recommended and implemented new or modified reporting based on department and client needs
• Identified and gathered data extracts to perform business analytics
• Interpreted, analyzed, and made recommendations regarding data accuracy and data collection needs and processes;
• Identified opportunities to enhance existing processes and to develop new data information processes and tools
• Assessed and improved data collection and reporting processes

Jessup, Pennsylvania

• Supported the execution of the company’s Compliance Plan
• Escalated areas of potential and actual non-compliance to Compliance Officer, Vice President, and Manager
• Investigated potential compliance issues
• Developed, implemented and executed internal monitoring programs
• Fulfilled oversight and monitoring related requests
• Supported Management with the facilitation and coordination of CMS activities including, but not be limited to, coordination with Operations for the development of BRDs, universes, and audit samples

Jessup, PA

• Developed and delivered accurate agent workforce forecasts and schedules for the inbound/outbound Customer Care business and managed contact center activities, both real-time and planned for four contact centers.
• Developed workload forecasts for the Ancillary Support department and assisted with plans for effective distribution of work within multiple call centers.
• Managed the Workforce Management Command Center and made intra-day tactical management decisions associated with maintaining both client contract and internal contact center objectives.
• Worked with the Workforce Management team to oversee staffing and hiring requisition development based on new client activities, analysis of call patterns, call volume, available personnel and adjusted departmental.
• Analyzed data trends in call patterns, product variability, turnover, hiring, and budgeting.

Jessup, PA

• Managed employee payroll hourly tracking/reconciliation and attendance tracking.
• Developed new streamlined protocol for employee data information including but not limited to attendance, status, and disciplinary actions.
• Reported daily on employee statistics (key performance indicators such as utilization, average handle time, and quality control results).
• Managed employee workloads and daily utilization.
• Responsible for employee performance reviews (quarterly/annually).
• Monitored/managed live call queue.

Jessup, PA

• Provided timely assistance to Customer Service Representatives as a subject matter expert on an as needed basis.
• Assisted production supervisors with daily reporting of utilization and average call handle time.
• Developed protocol for tracking Assist Line inquiries in order to establish need based one-on-one coaching.

Jessup, PA

• Participated as a member of the front line staff (Customer Service Representative).
• Provided solutions for Enrollment and Billing inquiries for a Medicare Prescription Plan.
• Assisted other departments (e.g., Ancillary, Support Services, Appeals and Grievances) within the company on an as needed basis.
• Responsible for processing Coordination of Benefits surveys, Late Enrollment Penalty attestations, Best Available Evidence requests, and RFI responses.

Education record

Education record