Ashia Reynolds
Plano,TX
Summary
Self-motivated and results-driven healthcare auditor with strong ability to analyze large data sets. Knowledgeable in QA methodology with proven history of reducing errors to increase quality. Strong organizational skills and flexibility to shift focus depending on team needs and priorities with a track record of dependability and leadership. Ability to work independently or in a team environment. Capable of grasping new concepts and systems quickly.
Overview
8
8
years of professional experience
Work History
Payment Accuracy Specialist I
Cotiviti
05.2022 - Current
- Perform weekly quality and validation assessments on pending audits
- Identify audit discrepancies and provide training for team when necessary
- Conduct process and system audits to identify areas of improvement and enforce compliance
- Meet with production and development team weekly to discuss areas of improvement and quality issues of the audit
- Test developmental audit projects and provide recommendations to engineering and production teams
- Produce moderately complex SQL queries to identify additional audit opportunity
- Monitor project progress and take corrective action as needed
- Analyze large data sets and determine trends
Payment Accuracy Specialist
Cotiviti
06.2020 - 05.2022
- Audit medical claims for client by analyzing large data sets
- Use knowledge of ICD-9/ICD-10, revenue, CPT, APC, and DRG codes, CMS pricing guidelines, and contract interpretation to accurately price claims
- Work on special audit projects as assigned
- Research new audit concepts
- Meets bi-weekly with production and development team to discuss new audit concepts and support for team
- Research and calculate patient insurance contributions
- Communicate pricing discrepancies to the client and provide error correction
- Consistently meet and exceed monthly audit goals
Ophthalmic Technician
Constant Eye Care
02.2017 - 06.2020
- Insurance verification
- Schedule appointments
- Perform preliminary examinations including visual acuity, intraocular pressure, refraction, retinal photo, and visual field tests
- Record patient information using electronic medical record system
- Sell and fitting of glasses
- Teach insertion and removal of contact lens
- Train new employees
- Conflict resolution and address concerns of patients
Education
Bachelor of Science - Biology
The University of Texas At Dallas
12.2019
Associate of Science -
Richland Collegiate High School
05.2015
Skills
- Data analysis
- Project oversight
- Quality control
- Contract interpretation
- Critical thinking
- Data mining
- Microsoft Office Suite
- HIPAA compliance
- Insurance interpretation and verification
- Strong verbal and written communication
Timeline
Payment Accuracy Specialist I
Cotiviti
05.2022 - Current
Payment Accuracy Specialist
Cotiviti
06.2020 - 05.2022
Ophthalmic Technician
Constant Eye Care
02.2017 - 06.2020
Bachelor of Science - Biology
The University of Texas At Dallas
Associate of Science -
Richland Collegiate High School
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