Frances Sowells
Louisville,KY
Summary
Dynamic professional with extensive experience at HCA/Parallon, excelling in project coordination and compliance management. Proven track record in streamlining processes and enhancing productivity through data analysis and effective communication. Adept at leading teams and implementing quality assurance measures, ensuring adherence to HIPAA regulations while achieving operational excellence.
Overview
15
15
years of professional experience
Work History
Lead Consumer Correspondence Analyst
HCA/Parallon
Louisville, KY
05.2016 - Current
- Responsible for the design, programming, and implementation of statements, and consumer correspondence for hospitals and RCPS clients under the Parallon/HCA umbrella.
- Collaborate with other departments, such as Operations, Apps and ETL, to streamline processes and complete onboarding for new clients and hospital facilities.
- Ensure compliance with relevant healthcare regulations, including HIPAA, in all customer interactions and data handling processes.
- Works as a subject-matter expert in the State Regulatory Compliance Update department, particularly in consumer correspondence/billing statements.
- Gather, analyze, and interpret data to identify issues and opportunities.
- Work closely with legal department attorney follow-up to complete implementation or changes to patient consumer correspondence/billing statements.
- Develop and implement efficient workflows, tools, and technologies to streamline and enhance daily productivity.
- Generate regular reports and performance metrics to track data accuracy and adhere to expected operations/client desired outcomes.
- Lead team in onboarding of new clients/facilities by delegating work tasks to ensure departmental input meets project objectives and timelines.
- Participate in discussions regarding key project decisions.
- Deliver project deliverables with minimal guidance.
- Work with outside vendors to implement onboarding, and existing client changes. While ensuring data integrity consistently adheres to contractual obligations and goals.
- Participate in communications among all team members to ensure comprehensive understanding of needs, expectations and requirements.
- Set priorities for team tasks and activities.
- Attend required HIPAA Awareness and CCCO training.
- Assist in the development, implementation, and maintenance of appropriate team training, and procedures.
Insurance Service Unit Representative
HCA/Parallon
Louisville, KY
06.2015 - 05.2016
- Worked insurance pools and contact insurance companies to resolve claims that are not paid in a timely manner.
- Reviewed EOB’s, remits and payer correspondence while performing account follow-up and escalate any identified issues to the appropriate area for review and response to expedite claim resolution.
- Identified problem accounts and escalate as appropriate.
- Maintained compliance with pool completion requirements.
- Maintained required productivity and QA standards.
- Documented in the patient account record to identify actions taken on the account.
- Worked with guarantors to resolve payer requests and discrepancies to promptly resolve pending claims.
Contact Center Manager
YMCA
Louisville, KY
06.2013 - 11.2014
- Assisted with the selection and installation BCT call center software for implementation of new call center.
- Programmed call center back-office to support desired call center workflow and operation parameters.
- Accomplished call center human resource objectives through recruitment, training, and disciplinary actions.
- Oversaw the day-to-day operations of the customer care center, ensuring prompt and accurate response to customer inquiries, billing inquiries, and other service-related matters.
- Operated in a HR role, overseeing employee timekeeping and payroll in Dayforce HCM.
- Monitored key performance indicators (KPIs) such as call volume, average handle time, first-call resolution rate, and customer satisfaction scores to assess operational performance and identify areas for improvement.
- Identified opportunities for process optimization and automation to improve efficiency and reduce costs without compromising service quality.
- Defined operational strategies through needs assessments, performance reviews, and technology evaluations.
- Maintained a low turnover rate and met financial objectives within a $500,000 budget.
Quality Assurance Manager
Arise Virtual Solutions
07.2010 - 06.2013
- Company Overview: Virtual Based Company
- Managed Customer Service Representatives in a 100% virtual environment.
- Implemented quality assurance measures to maintain high standards of service delivery, including call monitoring, feedback sessions, and performance audits.
- Conducted compliance training sessions for customer service representatives to uphold confidentiality and data security.
- Virtual Based Company
Education
Master of Business Administration - Health Care Management
Indiana Tech
Fort Wayne, IN01.2019
Post Baccalaureate Paralegal -
Cuyahoga Community College
Cleveland, OH01.2010
Bachelor of Arts - Communications
University of Louisville
Louisville, KY01.2006
Skills
- Root cause analysis
- Trend analysis
- HIPAA compliance
- Quality assurance
- Project coordination
- Talent recruitment
- People leadership
- Data analysis
- Process improvement
- Compliance management
- Workflow optimization
- Reporting tools
- Project management
- Team leadership
- Problem solving
- Effective communication
Designations Certifications
Credit and Collections Compliance Officer, ACA International, 2016
References
References available upon request.
Timeline
Lead Consumer Correspondence Analyst
HCA/Parallon
05.2016 - Current
Insurance Service Unit Representative
HCA/Parallon
06.2015 - 05.2016
Contact Center Manager
YMCA
06.2013 - 11.2014
Quality Assurance Manager
Arise Virtual Solutions
07.2010 - 06.2013
Master of Business Administration - Health Care Management
Indiana Tech
Post Baccalaureate Paralegal -
Cuyahoga Community College
Bachelor of Arts - Communications
University of Louisville
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