Ashley Menser
Camp Hill,PA
Summary
Motivated professional eager to embrace new challenges. Demonstrates strong work ethic, adaptability, and exceptional interpersonal skills. Proven ability to work independently and rapidly acquire new competencies.
Overview
11
11
years of professional experience
Work History
Edi Analyst
Novitas Solutions
Mechanicsburg, PA
03.2022 - 04.2025
- Assisted providers, clearinghouses, and billing vendors with EDI enrollment for Medicare Part A and B.
- Analyzed EDI transactions to ensure compliance with industry standards.
- Collaborated with cross-functional teams to resolve data discrepancies.
- Facilitated account unlocks and password resets to ensure uninterrupted access.
- Reset acknowledgment reports and analyzed data for provider compliance.
Appeals Rep
Novitas Solutions
Mechanicsburg, PA
08.2019 - 03.2022
- Researched and processed Medicare Part B appeals to ensure compliance and accuracy.
- Assisted in adjusting and correcting claims for providers to maximize reimbursements.
- Communicated directly with healthcare providers to gather necessary documentation.
- Collaborated with internal teams to resolve complex appeal cases efficiently.
- Reviewed and analyzed appeal requests for accuracy and compliance with regulations.
- Managed case files and maintained detailed records in electronic systems.
- Provided guidance to clients on the appeals process and requirements.
- Drafted appeal decision letters to communicate outcomes effectively.
Senior Advisor
Novitas Solutions
Mechanicsburg, PA
07.2018 - 08.2019
- Resolved escalated issues for PSA, addressing supervisor calls and managing difficult providers.
- Advised leadership on strategic initiatives and organizational improvements.
- Collaborated with cross-functional teams to drive project outcomes and efficiencies.
- Assisted in developing policies and procedures for providing high quality customer service.
- Conducted research and processed escalations to ensure timely resolutions.
- Mentored new hires and provided refresher training for existing PSA staff.
Provider Service Advocate
Novitas Solutions
Mechanicsburg, PA
10.2014 - 07.2018
- Assisted providers with questions related to billing for Part A and Part B Medicare claims.
- Conducted research on denial issues to provide solutions for providers.
- Clarified health insurance policies and coverage options for clients.
- Addressed inquiries about claims processing and payment timelines.
- Collaborated with internal teams to swiftly resolve client issues.
- Educated clients on compliance regulations and documentation requirements.
- Managed case files, ensuring accurate records of client interactions.
Education
Diploma -
Upper Moreland High School
Willow Grove, PA06.2007
Skills
- Microsoft Word and Excel
- EDI enrollment
- Claims processing
- Customer relationship management
- EDI compliance
- Problem solving
- Effective communication
- Attention to detail
- HIPAA compliance
- Customer service training
- Active listening
- Conflict resolution
- CMS systems expertise
- HETTS knowledge
- HIMR proficiency
Timeline
Edi Analyst
Novitas Solutions
03.2022 - 04.2025
Appeals Rep
Novitas Solutions
08.2019 - 03.2022
Senior Advisor
Novitas Solutions
07.2018 - 08.2019
Provider Service Advocate
Novitas Solutions
10.2014 - 07.2018
Diploma -
Upper Moreland High School
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