Ashley McLean
Virginia Beach,VA
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
17
17
years of professional experience
Work History
Data VIIS Specialist
VDH-Virginia Beach, VA
12.2020 - Current
- Inputting data for immunizations relating to Covid-19
- Enhanced team productivity by streamlining processes and implementing time-saving strategies.
- Gathered, organized and input information into digital database.
- Collected, arranged, and input information into database system.
- Maintained database systems to track and analyze operational data.
CSR I/Release Of Information
CIOX Health-Virginia Beach, VA
06.2020 - 11.2020
- Responsible for processing all release of information (ROI) specifically medical record requests in a timely and efficient manner ensuring accuracy and providing customers with the highest quality product and customer service
- At all times safeguard and protect the patient's right to privacy by ensuring that only authorized individuals have access to the patient's medical information and that all releases of information are in compliance with the request, authorization, company policy and HIPAA regulations.
- Performed data entry for Medical Records
- Answered calls from Attorneys
- Processed Subpoenas
- Epic Experience
Customer Associate I
Conduent/Keefe Project (PT)-Virginia Beach, VA
02.2020 - 05.2020
- Handled incoming calls from various states by assisting with payments to place on commissary for incarcerated loved ones
- Data Entry and research
CCR 1/Claims Temp
Anthem, Inc.-Virginia Beach, VA
10.2018 - 01.2020
- Customer Care Rep 1-
- Answer inbound calls in different Markets for Medicaid
- Update account information verified by HIPAA
- Order I.D cards, Update PCP's and setup transportation for concierge markets
- Submit Complaints & Grievances
- Medical Appeals for members
- Claims-
- Facets, Macess & NextGen
- Provides Statuses of claims and adjudicates
- Fax/Mail EOPs to providers
- Submit Medical Appeals for Providers
- Process claims meeting departmental performance standards for production and quality.
- Report claims adjudication and/or claims system issues to management.
- Correctly analyze and adjudicate claims to reflect financial, check and processing accuracy
- Answer inquiries from members, providers and internal employees in a timely and accurate manner
- Offer outstanding customer service and follow-up to all members and providers.
Medical Documentation Reviewer III/ Claims(Vertexing)
DOMA Technologies LLC-Virginia Beach, VA
08.2015 - 06.2018
- Responsibilities
- Documents transactions in appropriate medical management system
- Writes responses to inquiries and processed authorizations
- Medical Terminology
- HIPPA
- Contacts health care provider offices by telephone, collects medical notes and forwards to the appropriate place
- Identifies, analyzes and resolves a variety of document and scheduling issues
- Contacts health care providers to confirm appointments
- Ability to navigate multiple computer systems, applications, and utilize search tools to find information
- Edited Claims ( UB04, HCFA & Reject Verify)
- Sent Reject Letters to Providers if the claim was denied for payment
- Skills Used
- Data Entry
- Communication Proficiency
- Organizational Skills
- Problem Solving/Analysis
- Office Experience
- Medical record documentation
- Microsoft Outlook
- Computer Skills
Customer Service Coordinator
Capital One Call Center-Chesapeake, VA
11.2012 - 07.2015
- Responsibilities
- Assisted with customer complaints
- Technical support
- Verification of account information
- Account closure/retention
- Activation of new credit cards
- Skills Used
- Data entry
- Attention to detail
Customer Service Representative
Aaron's Sales and Lease-Snellville, GA
01.2007 - 10.2012
- Responsibilities
- Sales & Marketing
- Maintained up-to-date knowledge of customer accounts
- Explained products and benefits
- Data entry
- Answering phones
- Filing & processing files manually and electronically
- Receptionist
- Skills Used
- Organizational skills
- Data entry skills
- Attention to detail
- Multi-task
- Administrative Assistance
- Cash Handling
Education
High school or equivalent -
Landstown High School
Virginia Beach, VA01.2004
Skills
- EMR Systems
- HIPAA
- Medical Records
- Medical Terminology
- Typing (10 years)
- Epic
- Medical Office Experience
- Data Entry
- Analysis skills
- Managed care
- Customer service
- Typing
- Technical support
- Medical terminology
- Windows
- Medical records
- Documentation review
- Research
- Marketing
- EMR systems
- Sales
- Data entry
- English
- Data collection
- Qualitative research interviewing
- Computer skills
- Phone etiquette
- Communication skills
- Customer support
- CRM software
- Microsoft Excel
- Microsoft Word
- Microsoft Office
- Time management
- Search engines
- CRM software (6 years)
- Outbound calling
Data Analysis
Documentation Management
Quality Assurance
Expert Problem Solving
Personal Information
Title: Senior Customer Service Representative
Awards
- Medical Documentation Reviewer of The Month
- Top Producer
Timeline
Data VIIS Specialist
VDH-Virginia Beach, VA
12.2020 - Current
CSR I/Release Of Information
CIOX Health-Virginia Beach, VA
06.2020 - 11.2020
Customer Associate I
Conduent/Keefe Project (PT)-Virginia Beach, VA
02.2020 - 05.2020
CCR 1/Claims Temp
Anthem, Inc.-Virginia Beach, VA
10.2018 - 01.2020
Medical Documentation Reviewer III/ Claims(Vertexing)
DOMA Technologies LLC-Virginia Beach, VA
08.2015 - 06.2018
Customer Service Coordinator
Capital One Call Center-Chesapeake, VA
11.2012 - 07.2015
Customer Service Representative
Aaron's Sales and Lease-Snellville, GA
01.2007 - 10.2012
High school or equivalent -
Landstown High School
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