Hi, I’m
Ashley Dlugokeski
Abingdon,MD
Summary
Revenue recovery professional with deep expertise in managing financial discrepancies and optimizing recovery processes. Known for fostering team collaboration and delivering reliable results in dynamic environments. Skilled in data analysis and strategic problem-solving, consistently ensuring operational efficiency and accuracy.
Overview
18
years of professional experience
Work History
R1RCM
Denials & AR Supervisor
06.2022 - Current
Job overview
- Oversee the daily work of up to 20 team members, selecting, developing, and directing team members, and assisting team members with problematic claims
- Mentor employees, conduct performance evaluations, counsel and provide disciplinary actions to assigned personnel, and work to facilitate individual and team development that drives positive results through positive communication
- Analyze hospital outpatient data to identify client recovery trends and provide feedback to clients for denial prevention
- Assign projects to increase inflow and optimize revenue recovery
- Build and maintain strong client relationships
- Adhere to set key performance indicator expectations
- Ensure that inventory remains within established protocols through effective management of the teams
- Assist with month-end process, including audits, payment reviews and reconciliation
R1RCM
Denials & AR Lead
10.2021 - 06.2022
Job overview
- Communicate goals and deadlines and ensure that supervisors remain updated and informed on projects and inventory status
- Perform account closures
- Ensure accounts are worked according to client protocols
- Provide training/mentorship and education as needed
- Assist new hires and with concerns, issues, and questions
- Perform account reviews and assists with inventory audits both internally and for client facing reporting
- Maintain responsibility for high dollar account inventory
- Support meeting the expected key performance indicator standards
- Identify for and communicate ideas to improve operational efficiency
- Escalate payer issues and trends to supervisor for communication with client
- Perform monthly audits and payment reviews
- Review and apply contact language and rates as necessary to resolve denied claims
- Advanced understanding of healthcare reimbursement methodologies
- Participate in client meetings as necessary
R1RCM
Denials & AR Analyst II
05.2017 - 10.2021
Job overview
- Conduct research (contract & payer level) to determine the root cause of stalled claims and/or denials
- Write appeals and other correspondence to payers to overturn denials or resolve payer delay
- Appeal and claim follow-up to exhaustion or payment
- Complete basic & complex initial reviews
- Expert in navigating client system(s) to obtain necessary data to overcome stalled claim and/or denial
- Utilize payer portals to verify patient benefits and eligibility, obtain claim status and follow up on appeal status
- Utilize internal software platform for workflow documentation and tracking
- Escalate complex accounts to client or provider representative
- Understand and utilize payer contracts and provider manuals in the initial review, appeal and follow-up process
- Intermediate understanding of revenue cycle concepts, to include medical coding definitions, billing form requirements, ICD-10, HCPCS/CPT, revenue codes and medical terminology
Intersect healthcare
Appeal coordinator
03.2015 - 04.2017
Job overview
- Serve as a liaison in corresponding and communicating between the client and the insurance company as needed during appeal processing
- Acquire and maintains all documentation associated with the processing and handling of appeals to comply with regulatory standards and time frames while maintaining an accurate, complete appeals record in the electronic database
- Conduct general appeal research including, but not limited to, requesting waivers of liability and/or appointment of representative forms, organizational determination research, requesting member medical records, organizing documentation, processing the review of case, documentation of the appeal resolution and sending completed case files to external review organizations as required by regulatory guidelines
- Assign cases that require an appeal to be written, using Ad Hoc Reports, to 40+ Independent Medical Reviewers based on their weekly availability
- Develop and presents ideas for performance and process management improvement within the department
- HIPAA Certified
Keller Williams American Premier Realty
Executive Assistant
01.2013 - 01.2015
Job overview
- Oversee all aspects of buyers/sellers transactions from contract to settlement
- Coordinate with buyers/sellers on photographs, inspections, repairs and marketing activities
- Input and maintain listing information in the MLS and marketing websites
- Manage client database management program and system
- Prepare listing and open house flyers, signs and other marking materials
- Submit required documentation to the officer broker for compliance review
- Manage and enhance agent’s social media presence and online marketing
The Warner Graham Company
Product Coordinator / Customer Service Manager
10.2006 - 01.2013
Job overview
- Input and maintain incoming purchase orders
- Accounts Receivable / Accounts Payable
- Provide services to 125+ customers such as order placement and account information
- Represent the company at Trade Shows and Conventions
- Serve as a liaison between the office and the warehouse
- Create a daily shipment schedule for the warehouse
- Maintain detailed reports documenting any material damage or loss
- Communicate verbally and in writing to answer inquiries and provide information
Education
Towson University, Towson, MD
Bachelor of Science from Forensic Chemistry
12.2016
Skills
- Problem-solving
- Collaboration
- Healthcare revenue cycle analytics
- Performance metrics monitoring
- Payment reconciliation
- Strong communication skills
References
Available upon request.
Timeline
Denials & AR Supervisor
R1RCM
06.2022 - Current
Denials & AR Lead
R1RCM
10.2021 - 06.2022
Denials & AR Analyst II
R1RCM
05.2017 - 10.2021
Appeal coordinator
Intersect healthcare
03.2015 - 04.2017
Executive Assistant
Keller Williams American Premier Realty
01.2013 - 01.2015
Product Coordinator / Customer Service Manager
The Warner Graham Company
10.2006 - 01.2013
Towson University
Bachelor of Science from Forensic Chemistry
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