Ashley Gibson
Mesquite
Summary
Professional with background in claims processing and customer service. Known for strong analytical skills, effective communication, and adaptability in dynamic environments. Focus on team collaboration and achieving results, ensuring reliable support and flexibility with changing needs. Skilled in data entry, problem-solving, and maintaining accurate records, with keen eye for detail and strong organizational abilities.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Claims Intake Specialist
Molina Healthcare (via Merit Consulting Corporation)
10.2023 - 07.2025
- Processed high-volume Medicaid and Medicare claims in compliance with CMS and state regulations.
- Verified eligibility, enrollment, and benefits using payer portals and internal systems.
- Entered and reviewed claim data using platforms including QNXT, Availity, Epic and Microsoft Excel.
- Validated required billing elements such as taxonomy, NPI, ICD-10, and CPT/HCPCS codes.
- Flagged incomplete submissions and routed them for correction.
Administrative Assistant
City of Hope (via Iconma)
10.2022 - 10.2023
- Coordinated travel arrangements for staff attending business events and conferences.
- Tracked timelines and budgets, supporting cost-efficient project completion.
- Provided administrative and communication support across departments.
- Assisted with event planning including scheduling, venue booking, and logistics.
Senior Data Entry Specialist
Cuna Mutual Group (via Apex Systems)
05.2021 - 10.2022
- Entered, reviewed, and verified high-volume patient and claims data with 99%+ accuracy.
- Identified and corrected discrepancies to ensure HIPAA compliance and data integrity.
- Maintained and updated electronic health records (EHR) and claims management systems.
- Generated reports and summaries to support clinical, billing, and care management teams.
- Trained and assisted staff on data entry workflows, healthcare systems, and best practices.
Insurance Verification Specialist
Evolent Healthcare (via Acro Service Corporation)
08.2020 - 08.2021
- Verified patient insurance coverage and documented benefits and authorizations.
- Collaborated with providers and internal teams to resolve eligibility issues.
- Communicated with patients regarding financial responsibility and coverage.
Claims Processor
Kemper Insurance (via Merit Consulting Corporation)
01.2020 - 07.2020
- Reviewed, processed, and adjudicated PIP insurance claims accurately and in compliance with state regulations.
- Verified policy coverage, limits, and patient eligibility before claim approval.
- Coordinated with healthcare providers, insurance carriers, and policyholders to resolve discrepancies or missing information.
- Entered and updated claim data in claims management systems, ensuring timely processing.
- Monitored claim status and generated reports to support management and billing teams.
- Assisted in identifying trends in claims errors or delays to improve workflow efficiency.
Customer Service Representative
Baylor Scott & White Health
06.2018 - 01.2020
- Handled high-volume calls and provided accurate patient information.
- Supported billing, insurance coordination, and financial assistance.
- Processed medical claims and resolved billing discrepancies.
Education
High School Diploma -
Lake Highlands High School
Dallas, TXSkills
- Claims Processing & Intake
- Denials & Appeals
- Medicaid / Medicare Regulations
- Insurance Verification
- EMR & Claims Systems (QNXT, Facets, WGS)
- HIPAA Compliance
- Administrative Support
- High-Volume Data Entry
Certification
Texas All Lines Adjuster License – Texas Department of Insurance (2025-06 – 2027-04)
Timeline
Claims Intake Specialist
Molina Healthcare (via Merit Consulting Corporation)
10.2023 - 07.2025
Administrative Assistant
City of Hope (via Iconma)
10.2022 - 10.2023
Senior Data Entry Specialist
Cuna Mutual Group (via Apex Systems)
05.2021 - 10.2022
Insurance Verification Specialist
Evolent Healthcare (via Acro Service Corporation)
08.2020 - 08.2021
Claims Processor
Kemper Insurance (via Merit Consulting Corporation)
01.2020 - 07.2020
Customer Service Representative
Baylor Scott & White Health
06.2018 - 01.2020
High School Diploma -
Lake Highlands High School