Ashley Mack
Ambler,PA
Summary
Dedicated cybersecurity professional with an Associate's degree in Cybersecurity and Networking, complemented by hands-on experience managing sensitive data in healthcare settings. Proven ability to investigate discrepancies, resolve system-related issues, and ensure compliance with data privacy regulations. Well-versed in network security fundamentals, threat detection, and system troubleshooting. Recognized for attention to detail, strong analytical skills, and effective problem-solving abilities, contributing to enhanced security measures and operational efficiency.
Overview
19
19
years of professional experience
Work History
Provider Claims Service Representative
AmeriHealth Caritas
Philadelphia, PA
08.2022 - Current
- Consistently met or exceeded individual performance metrics, including call handling time, first-call resolution rate, and customer satisfaction scores
- Help providers with all information about CPT codes such as authorizations, restrictions, fee schedules, and correct diagnosis codes.
- Claim resolution, EDI issues, appeal status, provider recruitment, and authorization or referral information.
- Provide unbias assistance to Medicaid providers with questions regarding Medicaid patient eligibility, medical claims statuses, and other program questions.
Medical Biller/AR Specialist
Mid Atlantic Retina
Plymouth Meeting, PA
11.2019 - 08.2022
- Research Medicaid denied and non payment claims for Pennsylvania, New Jersey, and Delaware.
- Make and receive phone calls from insurance companies and patients.
- Send out appeals and follow up with insurance companies.
- Prepare statements and process patient payments.
- Work all advanced denials that pertain to the specific advanced denial unit assigned, including but not limited to, Provider Enrollment, Duplicate Claim, and Timely Filing and/or Medical Necessity denials.
Medical Biller / AR Follow Up Representative
Alliance Cancer Specialists
Philadelphia, PA
02.2019 - 11.2019
- Thoroughly researches denied claims and provide quick and practical resolutions; results in Zero, delayed or denied claims within areas of responsibility.
- Preparing and Submitting Hospital Claims to Insurance Companies.
- Answering all insurance and patient calls pertaining to accounts and bills.
- Call insurance companies regarding incorrect denials and discrepancy in payments.
AR Follow UP Representative
Holy Redeemer/ Accountemps
Philadelphia, PA
12.2018 - 02.2019
- Reviewed accounts to determine reason for denial
- Researched missing payments
- Worked assigned underpaid and unpaid claims
- Followed up on claims with phone calls to insurance carriers.
Medical Biller / Insurance Denial Representative
Reimbursement Tech
Conshohocken, PA
05.2013 - 12.2018
- Process rejections, denials and other correspondence received from third party insurance in accordance with RTI procedures and guidelines in an effort to resolve non-payment issues and rebill "clean" claims for payment.
- Document accounts worked through the system notes screen.
- Investigate insurance rejections and denials and communicate findings to appropriate management personnel.
- Work all Advanced Denials that pertain to the specific Advanced Denial unit assigned, including but not limited to, Provider Enrollment, Duplicate Claim, and Timely Filing and/or Medical Necessity denials.
- Write and follow up on appeal letters sent to insurances
- Make outbound phone calls to insurance companies to discuss/resolve denied claims.
- Receive inbound calls from patients and insurances companies to resolve patient account issues
- Maintain proper inventory counts through the use of the system inventory control features.
Loss Prevention Officer
Jcpenney
Willow Grove, PA
08.2012 - 06.2013
- Conduct store surveillance on both employees and customers
- Apprehend shoplifters
- Inspecting the premises and knowing the signs that indicate theft
- Auditing certain areas such as inventory and the cash area
Security Guard
Diamond Security
Dallas, TX
11.2011 - 05.2012
- Monitored Dallas Love Field Airport
- Authorized the entrance and departure of employees
- Looked for any specious activity.
- Checked all badges coming into the Air Operation Gate.
Cashier
Joyce Leslie
Wyncote, PA
05.2007 - 01.2009
- Greet customers and ascertain what each customer wants or needs.
- Recommend, select, and help locate or obtain merchandise based on customer needs and desires.
- Answer questions regarding the store and its merchandise.
- Demonstrate use or operation of merchandise.
- Cashier
Education
Bachelor of Science - Cyber Security And Networking
DeVry University
05-2027
Associate's degree - Cyber security and Networking
DeVry University
10-2025
High School Diploma - undefined
Cheltenham High School
Wyncote, PA05-2009
Skills
- Threat Detection & Incident Response
- Time management
- Microsoft Office
- Excellent communication and teamwork skill
- Strong analytical and problem-solving abilitie
- Windows & Linux Operating Systems
- High attention to detail and accuracy
- Ability to work in fast-paced environments
- Network Security Fundamentals
- Risk & Compliance Awareness
- Security Monitoring Concepts
- TCP/IP Networking & Troubleshooting
- Vulnerability Scanning
Additional Information
Conducted vulnerability scans using Nmap in lab environments to identify potential network weaknesses, Analyzed network traffic using Wireshark to detect suspicious activity and anomalies, Configured basic system security settings, including firewall rules and user access controls, Practiced identifying common cyber threats such as phishing and malware in simulated environments.
Timeline
Provider Claims Service Representative
AmeriHealth Caritas
08.2022 - Current
Medical Biller/AR Specialist
Mid Atlantic Retina
11.2019 - 08.2022
Medical Biller / AR Follow Up Representative
Alliance Cancer Specialists
02.2019 - 11.2019
AR Follow UP Representative
Holy Redeemer/ Accountemps
12.2018 - 02.2019
Medical Biller / Insurance Denial Representative
Reimbursement Tech
05.2013 - 12.2018
Loss Prevention Officer
Jcpenney
08.2012 - 06.2013
Security Guard
Diamond Security
11.2011 - 05.2012
Cashier
Joyce Leslie
05.2007 - 01.2009
Associate's degree - Cyber security and Networking
DeVry University
High School Diploma - undefined
Cheltenham High School
Bachelor of Science - Cyber Security And Networking
DeVry University