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
Wilmington, NC
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
Raleigh, NC
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
Raleigh, NC
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, NH10.2021
Human Resource Development Certificate -
Wake Technical Community College
Raleigh, NC01.2013
High School Diploma -
Rosewood High School
Goldsboro, NC01.2006
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