Leslie Bewley

Experience

• 

  101.9 KBUS Radio

  May 1997 - Nov 1997

  DIRECTOR OF REGIONAL NETWORK NEWS

  ~ Coordinated five daily newscasts that were simulcast on three separate stations in the Northeastern Texas/Southeastern Oklahoma region~ Supervised a staff of three news reporters~ Assigned workload~ Covered area news and events~ Produced commercials~ Performed at live remotes~ Designed promotion presentations for potential customers~ Composed news stories, commercials, proposals, and public service announcements

• 

  Fannin Bank

  Nov 1997 - Jul 2001

  BANK TELLER

  ~ Entered and processed customer deposits, withdrawals, loan payments, and postings~ Trained new employees~ Served as vault-teller back-up~ Ordered money from the Dallas Federal Reserve Bank~ Maintained collection and floor note accounts

• 

  TrailBlazer Health Enterprises, LLC

  Jul 2001 - Nov 2006

  Took over a 15 member multi-functional team that did not have established performance standards or expectations. Call center wait times and abandonment rates were deplorable. Batching and tracking staff averaged more than 70 days to log receipts. Establishing staff accountability and production standards was 1st priority. In doing so, the following accomplishments were achieved.~ Improved each CSR’s staffed hours by an average of 14 hours per month, adding 70 hours (or 9.3 days) of customer service coverage per month~ Reduced each CSR’s After Call Work (ACW) usage by 5 hours per month, allowing the representatives to be available to callers for 25 hours more each month~ Improved the MSP phone service level to 66% within 8 months, when for years it had been 0-1%~ Increased the number of answered calls by 48% on average per month, through staff accountability and implementing automated options to the customer service line~ Reduced the dropped call rate by 6% within 6 months~ Reduced the average days for logging receipts from greater than 70 days to fewer than 10 within 6 months~ Supervised a staff of 15 employees responsible for incoming and outgoing cash receipts, refunds, correspondence and telephone inquiries ~ Interpreted SOW, CMS guidelines and change requests for implementation, communicated changes to internal and external customers and ensured control measures were in place to safeguard the Medicare Trust Fund~ Helped to ensure the successful transition of the MSP workloads to the national Medicare Recovery Contractor~ Managed projects and helped execute conversion activities for HIGLAS and MSPRC transitions Show less ~ Responded to incoming and outgoing phone inquiries from physicians~ Maintained extensive knowledge regarding: CMS guidelines, policies, and requirements~ Claims processing, denial reason codes, coverage policy, and CPT/ICD-9 coding~ Medical review, MSP, overpayments, COB, appeals/re-determinations, written corre-spondence, claims entry, and liability~ Utilized TrailBlazer resources including: company websites, CMS websites, MedTEXT, and newsletters~ Performed data corrections and aging resolutions~ Made daily judgments and rapid decisions regarding Medicare issues Show less

  • SUPERVISOR MEDICARE SECONDARY PAYER

    Feb 2005 - Nov 2006

  • CUSTOMER SERVICE REPRESENTATIVE

    Aug 2003 - Feb 2005

  • CLAIMS ANALYST

    Jul 2001 - Aug 2003
• 

  Community Specialty Hospital

  Nov 2006 - Oct 2007

  DIRECTOR CENTRAL BUSINESS OFFICE

  Inherited a 10 member business office staff in which the person with the longest tenure had been there only one month. The previous staff had all been released due to poor performance and the new Controller and CEO had just hired all new staff. The hospital had been missing out on thousands of billable service dollars for over a year. The situation was critical and had to be rectified with little guidance from my superiors, as they were also new to the company. The department had to be built from ground zero. Below are significant accomplishments achieved within a few short months:~ Reduced the AR balance from over $7M to fewer than $4M in 7 months by ensuring the timely processing of accounts and controlling AR aging to achieve optimal reimbursement ~ Improved the average days in AR from 68 to 42 within 7 months, generating faster revenue~ Created and implemented policies/procedures for all business office operations where none previously existed ~ Implemented a Quality Auditing Program for charge entry, AR posting, billing, collection and admission functions to ensure accuracy~ Directed the business office for a 90-bed specialty facility that included the following services: in-patient skilled nursing, psychiatric, medical stabilization, physical, occupational and speech rehabilitation, out-patient pain management services and a sleep study lab~ Developed reports and presentations regarding business office operations for board members and executive management on a monthly and quarterly basis~ Facilitated company meetings to ensure common goals, policies, and procedures were met by all employees~ Knowledge of Third Party Payers, Medicare and Medicaid regulations, CPT and ICD-9 coding, medical terminology, practice management billing systems and HIPAA Show less

• 

  TrailBlazer Health Enterprises, LLC

  May 2008 - Dec 2012

  MANAGER PROVIDER ENROLLMENT MEDICARE

  Brought on board to establish and implement performance standards where none existed. Staff accountability was at an all time low and quality suffered. Collaborated with management and led a 140+ member department to achieve significant results within 6 months. The following accomplishments were achieved:~ Reduce web-based inventory by 83% within 6 months, overall inventory by 81% and screening age by 92% within 7 months~ Improved CMS mandated performance objectives to 93% from 17% within 4 months~ Reduced application processing time for web by 75% and routine by 57% within 7 months~ Improved the inventory aged less than 45 days to 94% from 61% within 7 months~ Directly managed 25-30 analysts, ensuring individual and unit productivity, quality and timeliness standards were met ~ Operated within a $4M budget, ensuring contract performance and provider satisfaction were maintained~ Managed the enrollment of 120,000 providers annually by accurately interpreting CMS guidelines and change requests measuring the impact of policy and procedural changes to operations~ Facilitated multiple enhancements to internal operating systems to improve functionality, increase productivity, streamline workflow and reduce user error ~ Submitted multiple suggestions to CMS for Internet Based PECOS enhancements that were accepted and implemented by CMS~ Designed and implemented a new quality assurance program to guarantee compliance with Quality Assurance Surveillance Plans regulatory guidelines mandated by CMS ~ Implemented and monitored internal control measures, identifying areas in which process improvements should be incorporated to ensure risk mitigation~ Protected Medicare Trust Fund dollars by directing the efforts of analysts to be vigilant in the awareness and identification of potential fraudulent behavior, including fraud investigations ~ Specialized in multiple workloads including: IDTF, ASC, PXRS, CLIA, PAR, EFT, Flu Roster Billers and Internet PECOS Show less

• 

  Dialog Direct (formerly NOVO 1)

  Jul 2013 - Feb 2014

  CUSTOMER SERVICE ACCOUNT MANAGER

  Directed a customer service department with eleven supervisors and approximately 200 employees servicing four client campaigns. Brought in to help establish consistency in procedure and policy, create staff accountability and to ensure KPIs were met consistently among all campaigns.• Directed four campaigns that collectively handled 1.5M calls annually with annual revenues over $5.5M.• Experienced 22% growth in one campaign from 2012 through 2013.• Improved absenteeism by 3.4% among 11 supervisors by standardizing policy and ensuring consistency in administration among all teams, with some teams experiencing an individual improvement of 6-8%.• Reduced attrition rates by 6% and up to 8% in two campaigns by improving hiring, candidate screening processes and implementing nesting procedures that better support new agents. Show less

• 

  CGS Administrators, LLC

  Mar 2014 - Nov 2018

  Selected as the interim director to oversee program operations and customer service for five government contract that support Medicare provider care and cost improvement initiatives. I managed employees at multiple site locations in multiple states, including W@H employees of all professional levels. During this short time, I was responsible for several key projects that were successfully implemented at various levels of complexity. • Served on various contract proposal teams to draft operational approaches and evaluate labor requirements and price those according to complicated government policies and standards. Because of our team’s effort, we successfully secured several award wins, increasing our business portfolio year over year.• Helped lead the effort to transition all call centers from a long-standing call ticketing system to the newly mandated ServiceNow call inventory system by Centers of Medicare and Medicaid Services (CMS).• Led the team though the successful closeout of the HITECH Business Operations Support Contractor for Electronic Healthcare Records (EHR) during the spring of 2018. During the closeout, our team maintained exceptional ratings on all program metrics, even when call volumes increased 200% to over 450% over CMS forecasted levels. • During all the special efforts listed above, as well as the day to day updates, issues and process improvements that are a part of routine operations within a call center environment, the information center achieved 100% of all Service Level Agreements (SLAs), exceeding the majority of measures throughout all of 2017 and 2018. Show less Managed three contracts for the Centers of Medicare and Medicaid Services (CMS) that handled inbound inquiries, both electronic and telephonic, for the Accountable Care Organizations (ACO) Information Center, Physician Value-Based Payment Modifier Program and Electronic Healthcare Records Information Center. Tasked with improving communication and strengthening relationships with business partners. The following are some achievements experienced during my time with CGS:• Revamped SLOs to go beyond the basic requirements and instead provide service to our customers that consistently scored at “exceptional” levels defined by CMS, ultimately resulting in award fee payments based on performance, even when faced with 8 of 12 months in which call volume was 20% to 463% greater than forecasted. • Facilitated multiple IVR enhancements using call ticket data trending and IVR usage reports that yielded 10% improved performance of the IVR menu and offered options that were better aligned to customer needs.• Stood up multiple call centers for new contract models under the BOSC umbrella under extremely tight deadlines. Call centers offered full-service IVRs, robust script libraries, call recording, auditing capabilities and standard operating procedures.• Implemented SharePoint tools to better track workforce and operational initiatives, creating a one-stop place to house information that is easily accessible, centrally located and that can generate reports based on parameters set by the end user. Show less

  • DIRECTOR PROGRAM OPERATIONS | CUSTOMER SERVICE

    Jan 2018 - Nov 2018

  • MANAGER PROGRAM OPERATIONS | CUSTOMER SERVICE

    Mar 2014 - Jan 2018
• 

  Health Care Service Corporation

  Nov 2018 - now

  Brought on board to assume leadership of our Texas and Oklahoma Health Advocacy Solutions clients, supporting an organization of ~230 advocates and 18 leaders. Our team offers the highest echelon of customer service support employers can purchase for its employees, assisting members through whatever need they may have, taking on the burden of navigating the complexities of the healthcare system so we can provide members with holistic resolution and hope for improved health and wellness outcomes. Below are some areas of influence I have helped achieved to date.• Manage the performance and service delivery to 48 TX/OK clients, serving ~500K member lives• Leadership of specialty teams that support the business across multiple states and serving 97 clients and 1.3M members, including Development Specialists, Outbound, AIM Shopper, Chat, and Secured Messaging teams.• Manage to 33.5M annual budget.• Realized $4.1M in OpEx savings in 2022 through streamlining efforts and efficiencies measures put in place to better support our customers and organization.• Achieved an additional OpEx savings in 2023 of $3M in savings through additional consolidation efforts, workload restructuring, and realized improvements in staff retention rates. Show less Brought on board to grow the Health Advocacy Solutions service delivery model for our group services members. Manage a team of ~100 health advocates and leaders that support the healthcare needs of ~170K BCBS members, helping them navigate the complexities of healthcare and insurance. During my time in Health Advocacy, I have helped to achieve the following: • Supported 11 clients in 2019, increased to 21 in 2020 and 22 plus an additional 60-member specialty workload team in 2021. Manage 29% of the entire HAS advocate staff, as well as the shopper, outbound, inventory, chat & secured message teams and Development Specialists responsible for all training and communication for the division.• Designed and implemented a workflow and inventory management system for both Client Escalations and the Developmental Specialist (DS) team. The new workflow provides additional inventory oversight, consistency in the submission process, improved cycle times and reporting availability regarding the various workloads.• SME for performance management, including leading the implementation of Apollo’s scorecard for HAS, which provides greater access to performance data for the leadership team and individual employee.• Managed multiple initiatives that improved service delivery and/or advocate efficiency within the department. • Serve as a consultant for the Request for Proposal (RFP) team to speak operationally on behalf of HAS. Show less

  • EXECUTIVE DIRECTOR | GROUP MEMBERSHIP OPERATIONS

    May 2023 - now

  • DIRECTOR - GROUP HEALTH ADVOCACY

    Oct 2021 - May 2023

  • SR. MANAGER HEALTH ADVOCACY SOLUTIONS

    Nov 2018 - Oct 2021