Lenette Dudley

Background

About Lenette Dudley

I have over 20+ years of experience in the Healthcare field. I have experience in the following areas listed below. I can adapt to change and I’m a quick learner. I’m very proactive and reliable. I’m a highly motivated team player with excellent written and verbal communication skills. • Claims processing on a UB04 and HCFA claim form in Facets and QNXT • Assist with Coordination of adjustment projects • Reviewing pricing payments for Medicare and Medicaid LOB • Cost Outliers review for payment thru Webstrat application • Review X-12 files for 837I and 837P claims types • State complaint cases • Provider rebuttals and reviewing of underpaid or overpaid claims • Review of claims for authorization match thru Guiding Care Application • Member eligibility review thru EPACES • Coordination of Benefits for member’s primary insurance • Contracts and implementing provider contracts into Facets System • Salesforce to create cases for Configuration review and adding agreement ID to price the claim correctly • Running queries thru Business Desktop Intelligence • Assist with training staff and writing process and improvement documents • Manage a staff of 6 people • Supervisor for a group of 55 including Temps • UAT testing in Facets systems and create test cases by the product and benefit limit testing.