Felicia A. Pollard
Henrico,VA
Summary
Experienced healthcare professional with expertise as a
billing professional with proven track record in financial management and billing accuracy. Known for improving billing procedures and resolving discrepancies efficiently. Reliable team collaborator focused on achieving results and adapting to changing needs, with keen eye for detail and problem-solving skills.
Overview
12
12
years of professional experience
Work History
Enrollment/Eligibility-Billing Specialist
Curana Health
06.2017 - Current
- Support eligibility determinations and enrollments in compliance with Medicare Advantage policies.
- Perform retroactive adjustments in enrollments, disenrollments, reinstatements, as well as state, and county codes.
- Maintain knowledge of Medicare Chapter 2 Enrollment and Disenrollment guidelines.
- Establish policies and procedures for CMS monthly Enrollment Data Validation (EDV) audits.
- Assist in managing enrollment, eligibility, and billing for 11 Medicare Advantage Health Plans (ISNPs, DSNPs, and CSNPs) to ensure seamless operations.
- Review eligibility files to confirm data is in sync with MARx.
- Collaborate with internal teams (Part D, Sales, Contact Center, and Reporting) to enhance communication and improve processes.
- Assist with the development and implementation of systems to reflect annual benefits updates.
- Work in conjunction with the Compliance Department to ensure accuracy for timely metrics.
- Provide supporting documentation and actively participate in CMS one-third financial audits.
Operations Manager
Affiliated Computer Services
05.2015 - 06.2017
- Served as the primary escalation point for complex daily, weekly, and monthly processes.
- Monitored staff productivity and achievement of performance objectives.
- Planned, managed, and controlled the day-to-day activities for all projects for a team that provided operational support for a business unit or group with a full understanding of business priorities and impact.
- Developed, monitored, and maintained departmental standards while creating clinical integrity, and financial results.
- Met regulatory and contractual service level agreements (SLA’s).
- Participated in new client implementation meetings.
- Ensured appropriate staff training, evaluated staff performance, and recommended hiring, terminations, promotions, and salary action.
- Interacted with other departments to improve processes and procedures so that overall operations were improved.
Senior Project Support Associate Analyst
Affiliated Computer Services
08.2013 - 05.2015
- Served as an administrative liaison with others within and outside the organization regarding administrative issues related to purchasing, personnel, facilities, and operations.
- Assisted in budget preparation and control activities.
- Administered programs, projects, and/or processes specific to the operating unit served.
- Assisted in the preparation and control of records, statistics, and reports regarding operations, personnel changes.
- Led the team in day-to-day operations and ensured completion of the programs contract deliverable.
- Encouraged and fostered an environment of teamwork, communication, collaboration, and readiness for change.
Education
Bachelor’s Degree - Business Administration
Averett University
01.2012
Skills
- Healthcare Audits (CMS)
- Vendor Management
- Quality Assurance Programs
- Medicare Part D, and Chapter 2
- Enrollment & Eligibility Management (MAPDs)
- Reporting
- Project Management
- Effective Leadership
- PBM & Vendor Coordination
- Client Relations
- CMS Systems (eg Medicare Advantage Prescription Drug System-MARx)
Timeline
Enrollment/Eligibility-Billing Specialist
Curana Health
06.2017 - Current
Operations Manager
Affiliated Computer Services
05.2015 - 06.2017
Senior Project Support Associate Analyst
Affiliated Computer Services
08.2013 - 05.2015
Bachelor’s Degree - Business Administration
Averett University
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