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. • Experience with updating Microsoft SQL stored procedures to support reporting.

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• Assisted in department project work requiring reporting review and system lookup• Assisted in the implementation of reporting solutions

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• Supported development of ongoing activities related to the company’s Internal Medicare Monitoring Program including the development of Monitoring Plans and reporting, analysis of output for trends and outliers, and coordination with Operations for the development of Monitoring Action Plans (MAPs)

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 schedules based on needs. • 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.• Monitored/managed an ongoing work inventory operating within compliance deadlines.

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