Ashley Anderson
Case Manager
Floyds Knobs,IN
Summary
Dedicated support specialist proficient in managing patient cases and coordinating services. Expertise in fostering trusted relationships with patients and healthcare professionals to enhance care delivery. Committed to maintaining confidentiality and adhering to ethical standards while ensuring efficient communication and documentation.
Overview
17
17
years of professional experience
Work History
Case Manager
Valeris
06.2024 - Current
- Managed patient cases from initiation to closure, ensuring timely benefit investigations and prior authorization appeals.
- Assisted individuals with eligibility for available benefits.
- Participated in regular team meetings and in-house training sessions to boost group effectiveness.
- Adhered to ethical principles and standards to protect clients' confidential information.
- Coordinated support services and optimized communication between healthcare workers and patients.
- Managed caseloads effectively, ensuring timely documentation and reporting.
- Built trusted relationships with patients, prescribers, and stakeholders through proactive communication.
- Executed program welcome calls and post-investigation calls to clarify coverage options.
- Handled all client inquiries and managed HCP inquiries in compliance with business rules.
- Managed inbound calls according to program-approved FAQs, triaging patients as necessary.
- Provided personalized case management, including outreach to communicate benefits and next steps.
- Coordinated product shipments through patient assistance programs and monitored prior authorizations.
- Documented all activities within the Pharmacord Lynk system, adhering to business requirements.
Pharmacy Technician (In Training)
Walgreens Pharmacy
12.2023 - 06.2024
- Dedicated and detail-oriented, with knowledge of pharmacy operations, medication handling, customer service, and administrative duties.
- Strong ability to learn quickly, follow safety procedures, and assist pharmacists in providing quality patient care.
- Reliable team member with excellent communication and organizational skills.
- Processed prescriptions, prepared and labeled medication according to pharmacy standards.
- Assisted patient with questions, and insurance concerns, while maintaining confidentiality and compliance with HIPPA regulations.
- Collaborated with pharmacists, and healthcare providers to support patient care.
Audit Support Specialist (NB EOB) and Data Collection
Cotiviti Inc
06.2020 - 12.2023
- Obtaining the correct EOB for the newborn under the NAIC guidelines.
- Ensuring the proper insurance company is billed correctly and within a timely manner.
- Contacting the other insurance to make sure claims were paid and processed.
- Ensuring facility has received proper payment from the insurance company.
- Knowledge of NAIC guidelines as well as Medicaid and Medicare guidelines.
- Data collecting information from Citrix and gathering client information for auditing team to determine Medicare coverage for services.
ED Secretary
Clark Memorial Health
05.2019 - 06.2020
- Handled incoming callers, contacting physicians for patient consults and communications between ED physicians and PCP.
- Arranged and presented patient charts and coordinated all emergency events.
- Made transportation arrangements for ED patients and assisted in their transfers.
- Prepared and maintained records related to patient admission, discharge, test results and treatments.
- Maintained computerized records of physician orders for patient services.
- Developed and maintained professional and positive relationships with clinical and medical staff.
- Extensive experience of handling and performing administrative and clerical tasks of ED unit, with knowledge of data entry, filing, and bookkeeping practices.
- Commendable knowledge of medical terminology, codes, medications and familiarity with workplace safety measures, customer service and phone etiquette.
- Ability to execute assigned tasks and handle conflicts in an adverse situation successfully.
Bartender and Manager
Macs Hideaway
01.2010 - 03.2020
- Responsibilities include opening and closing the bar and restaurant as an active key holder, bar inventory, register and cash handling responsibilities.
- Required to follow all alcohol and ID laws current liquor license required by the state of Indiana.
- Maintaining and tracking cash sales and bank deposits regularly.
- Responsible for payroll, scheduling of staff, preparing cash banks, and organizing events.
- Provide excellent customer service and courtesy along with always displaying a professional attitude.
- Strong focus on time management and attention to detail as to not waste valuable product.
Inventory Control Specialist
Squire Boone Village
06.2014 - 07.2015
- Compile and maintain records of quantity, type, and value of material, equipment, merchandise, or supplies stocked in warehouse locations.
- Compare inventories to office records or compute figures from records to current inventory.
- Prepare reports, price lists, shortages, and assist in employees locating needed product.
- Ordering of needed product and tracking purchases and losses.
Education
Health Information Coding -
DeVry University
OnlineBilling and Coding Specialist - Associates of Applied Science
Ivy Tech Community College
Sellersburg, INSkills
- Attention to detail and accuracy
- Problem assessment and resolution
- Customer service excellence
- Medical knowledge
- Multi-tasking ability
- Positive attitude
- Recruitment and office management
- Data verification and error correction
- Safe servers of Indiana expertise
- Micros POS system proficiency
- QuickBooks experience
- Outlook proficiency
References
Available upon request.
Timeline
Case Manager
Valeris
06.2024 - Current
Pharmacy Technician (In Training)
Walgreens Pharmacy
12.2023 - 06.2024
Audit Support Specialist (NB EOB) and Data Collection
Cotiviti Inc
06.2020 - 12.2023
ED Secretary
Clark Memorial Health
05.2019 - 06.2020
Inventory Control Specialist
Squire Boone Village
06.2014 - 07.2015
Bartender and Manager
Macs Hideaway
01.2010 - 03.2020
Health Information Coding -
DeVry University
Billing and Coding Specialist - Associates of Applied Science
Ivy Tech Community College