Ashley Mouser-Tucker
Bardstown,KY
Summary
Experienced compliance professional specializing in credentialing records, audit reviews, and regulatory reporting. Expertise in maintaining statutory records, investigating compliance issues, and facilitating external regulatory reviews. Committed to accurate documentation and timely issue resolution while fostering strong relationships with colleagues and clients.
Overview
10
10
years of professional experience
Work History
Senior Compliance Professional
Humana
Louisville, Kentucky
01.2017 - Current
- Conducted file, facility, and policy audits to ensure adherence to regulatory standards and participated in external regulatory reviews to enhance compliance practices.
- Investigated compliance issues and documented corrective actions to resolve discrepancies and improve overall compliance posture.
- Completed in-depth reviews of audit reports, client actions and monitoring activities.
- Tracked compliance cases through Humana issue management systems to monitor progress and maintain up-to-date records of compliance activities.
- Interpreted CMS guidance for Humana health plan procedures.
- Ensured that necessary records were maintained accurately according to statutory requirements.
- Organized a database of credentialing documents including licenses, policies, files, rosters, and minutes to ensure easy access.
Education
Master of Arts - RehabilitationCounseling
University of Kentucky
Lexington, KY12-1998
Skills
- Regulatory compliance
- CMS guidance
- Audit reviews
- Risk assessment
- Issue tracking
- Policy interpretation
- Credentialing records
- Audit Presentation
- Customer service
Timeline
Senior Compliance Professional
Humana
01.2017 - Current
Master of Arts - RehabilitationCounseling
University of Kentucky