Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

ASHLEY HOLMES

Raleigh,NC

Summary

Results-driven solutions specialist experienced in collaborating with teams to seamlessly integrate innovative solutions that meet business needs. Highly adaptable and excels in dynamic environments, utilizing strong problem-solving, strategic planning, and customer relationship management skills. Recognized for reliability and ability to align with evolving project requirements, consistently delivering high-quality service as a valued team player. Adept at facilitating cross-departmental collaboration with management and top-level leadership. Diligent trainer and mentor with a solid 5-year background in customer service and provider enrollment. Thrives in fast-paced environments, leveraging exceptional interpersonal and communication skills to ensure accurate writing and effective communication. Creates a dynamic and positive workplace culture that aligns with the organization's mission and values.

Overview

11
11
years of professional experience

Work History

Revenue Cycle Solutions Specialist

Wilmington Health, PLLC
09.2023 - Current
  • Trained internal teams on new software applications, empowering them to better serve clients with up-to-date knowledge.
  • Increased records accuracy by effectively maintaining confidential patient databases.
  • Conducted thorough analyses of client needs to ensure tailored solutions that addressed unique challenges and goals.
  • Participate in efforts to identify different or new technologies to adapt to clinic needs.
  • Maintain clinic fee schedules, working with application support teams to load any changes into the practice management and electronic health record systems as appropriate.
  • Analyze clinic fee schedules against negotiated payer fee schedules, preventing under billing
  • Build dashboards to display key performance indicators and metrics for both operational and executive audiences
  • Compile data for and create revenue cycle monthly management reports
  • Identify trends and abnormalities in revenue cycle data, running ad hoc reports to assist with root cause analysis
  • Maintains confidentiality and protects sensitive data at all times.
  • Meets highest compliance standards for all Federal and State regulations, including but not limited to, HIPAA, HITECH, Privacy, False Claims Act, etc.

Provider Enrollment Team Lead

GDIT, Inc
11.2021 - Current
  • Identify barriers and trends in respective inventory, collaborating with PE leadership to resolve the issue and notify/train the assigned staff members
  • Maintain trending reports and emailing it out to PE team daily
  • Identify patterns, spikes and trends to aid in mitigation
  • Review, escalate, and resolve aged inventory
  • Assist with staff onboarding and ongoing staff questions
  • Independent processing of assigned tasks, escalating timely and through fulfillment when tasks require additional attention for completion
  • Audited team of approximately 10 team members' performance and compliance with policy interpretations and desk procedure standards
  • Led professional and thorough orientation and training sessions, introducing new hires to key department information and processes
  • Monitored new hire performance, compliance and progress with requirements to consistently meet quality & performance guidelines
  • Reviewed onboarding processes regularly, identifying and correcting deficiencies
  • Wrote and created training material and presentations for onboarding employees
  • Trained new team members by relaying information on company procedures and safety requirements.
  • Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
  • Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
  • Collaborated with other department leads to streamline workflows, improve interdepartmental coordination, and achieve business goals collectively.
  • Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.

Healthcare Claims Administrator II

GDIT, Inc
11.2013 - 10.2021
  • Responsible for completion of provider enrollment applications and continuously exceeded weekly goal of 175 applications
  • Maintain documentation and reporting regarding provider enrollments in process
  • Retain records related to completed provider enrollments
  • Access Microsoft Outlook to access job-related information generated by the State
  • Interacts professionally with providers and their ancillary staff to provide appropriate and timely response to inquiries and concerns regarding provider's active enrollment
  • Maintain strict confidentiality of information as dictated by current HIPAA requirements
  • Assists in the process of running background checks for providers and associated relationships with the LexisNexis system
  • Responsible for fingerprint-based background checks for all high categorical risks providers designated by the State

Education

Bachelor of Arts - Mathematics

Southern New Hampshire University
Hooksett, NH
10.2021

Human Resource Development Certificate -

Wake Technical Community College
Raleigh, NC
01.2013

High School Diploma -

Rosewood High School
Goldsboro, NC
01.2006

Skills

  • Data Visualization
  • Pattern Recognition
  • Datasets/Data Processing
  • Acclimated to all Microsoft programs
  • Special Project Lead
  • Production monitoring
  • Performance improvement
  • Employee Evaluation
  • Customer Relationship Management
  • Attention to Detail
  • Team Collaboration

Accomplishments

  • Awarded company quarterly bonus by CEO
  • Participated in the specialized training of Managed Care Overrides
  • 100% Quality Progression
  • Customer Service Superior Award
  • Commended on achieving KRA goals

Timeline

Revenue Cycle Solutions Specialist

Wilmington Health, PLLC
09.2023 - Current

Provider Enrollment Team Lead

GDIT, Inc
11.2021 - Current

Healthcare Claims Administrator II

GDIT, Inc
11.2013 - 10.2021

Bachelor of Arts - Mathematics

Southern New Hampshire University

Human Resource Development Certificate -

Wake Technical Community College

High School Diploma -

Rosewood High School

Similar Profiles

CREATE PROFILE
ASHLEY HOLMES