Jennifer Frankenfield
Lehighton,PA
Summary
Analytical healthcare professional focused on quality audits, operational reviews, and claims processing accuracy. Maintains audit databases and monthly reporting tools, evaluates procedural compliance, and supports workflow standardization, error reduction, and reliable performance across health insurance operations.
Overview
29
29
years of professional experience
Work History
Claims Auditing and Processing Coordinator
Lehigh Valley Health Network | Populytics Inc.
Allentown, PA
01.2021 - Current
- Execute audit procedures to evaluate processing accuracy, procedural compliance, and adherence to organizational policies and regulatory requirements across multiple operational areas, including Enrollment, Claims, Customer Service and COBRA.
- Analyze audit findings, identify trends and potential operational risks, and provide recommendations to improve quality, consistency, and efficiency.
- Collaborated with management and operational teams to address audit findings and implement corrective action initiatives.
- Developed and maintained audit databases, performance metrics, and monthly reporting tools that enabled leadership to effectively monitor operational performance.
- Consistently exceed productivity, quality, and service goals while maintaining exceptional accuracy and compliance standards.
Benefit Analyst
Lehigh Valley Health Network | Populytics Inc.
Allentown, PA
01.2013 - 01.2021
- Analyzed enrollment information, medical claims, and benefit provisions to ensure accurate adjudication and compliance with plan requirements.
- Investigated complex claims and identified discrepancies requiring further review or corrective action.
- Collaborated with internal departments to resolve operational issues, ensuring timely claims processing and reducing delays.
- Provided expertise on benefit interpretation, claims processing guidelines, and regulatory requirements to support compliance, quality assurance, and operational consistency.
- Supported reporting and analysis activities to identify trends, contributing to strategic decisions for operational enhancements.
Senior Claim Benefit Analyst
Aetna
Allentown, PA
01.2001 - 01.2012
- Performed detailed research and analysis of enrollment, benefits plans, provider contracts, and claim data to ensure adjudication acuracy.
- Evaluated claim transactions to identify errors, inconsistencies, and process improvement opportunities.
- Chosen for the First Call Resolution Team to investigate root causes of claim processing issues and recommend process improvements.
- Collaborated with management and operational departments to implement corrective actions and improve quality outcomes.
- Contributed to department performance goals through analytical review and resolution of complex claim issues.
Customer Service Representative
Aetna
Allentown, PA
01.1998 - 01.2000
- Utilized effective communication and problem-solving skills to address customer needs, fostering positive customer experiences.
- Resolved member and provider inquiries related to eligibility, benefits, claims, and authorizations while ensuring accurate information, effective communication, and timely issue resolution.
- Ensured adherence to quality standards in a fast-paced, high-volume environment, contributing to consistent service delivery.
- Investigated complex issues, documented findings, and communicated conclusions clearly to support timely and operational accuracy.
Education
Northampton Community College
Bethlehem, PADiploma - Business and General Studies
Liberty High School
Bethlehem, PASkills
- Claims processing
- Benefit adjudication
- Claims analysis
- Enrollment verification
- Medical terminology
- HIPAA compliance
- Microsoft Office skills
- Analytical thinking
- Effective communication
- Written communication
- Health insurance
VOLUNTEER EXPERIENCE
- Lehighton Area High School, Parent Club Board Member, 2020, Present, Serve in leadership roles including Vice President, Secretary, and Treasurer., Coordinate fundraising activities, team events, and organizational initiatives to support athletic programs and student-athlete development.
- Franklin Township Athletic Association, Team Mom Volunteer, 2004, 2020, Assisted coaches in organizing team activities, events, communications, and player support initiatives., Promoted a positive and engaging experience for athletes and families throughout each season.
Timeline
Claims Auditing and Processing Coordinator
Lehigh Valley Health Network | Populytics Inc.
01.2021 - Current
Benefit Analyst
Lehigh Valley Health Network | Populytics Inc.
01.2013 - 01.2021
Senior Claim Benefit Analyst
Aetna
01.2001 - 01.2012
Customer Service Representative
Aetna
01.1998 - 01.2000
Northampton Community College
Diploma - Business and General Studies
Liberty High School