Ashley Nesbit
O'Fallon,Missouri
Summary
A results-driven professional with a proven track record in leveraging comprehensive research, effective collaboration, and strategic communication to enhance operational efficiency and data integrity. At UnitedHealth Group, I played a key role in streamlining workflows, optimizing decision-making, and delivering actionable solutions. My expertise in foreclosure research, process enhancement, and cross-functional collaboration consistently supports organizational goals and drives business success.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Senior Business Solutions Analyst - EPIC
Mercy Technology Services
Saint Louis, MO
10.2024 - Current
- Business Scope & Objective Definition: Conducted research and fact-finding to establish Epic Clinical Systems' requirements, aligning them with business and industry needs.
- Functional Analysis & System Configuration: Defined system requirements, configured application modules, and conducted testing to ensure functionality.
- Prototyping &Specification Development: Developed functional specifications, data mapping, function mapping, and configured transaction/control tables for system implementation.
- Business Process Analysis & Solution Development: Analyzed business requirements, ensuring a deep understanding of business processes, and developed tailored solutions.
- Gap Analysis & Resolution: Identified and resolved gaps in business processes, including security setup, user documentation, data interfaces, migration, and reconciliation.
- System Installation & Performance Tuning: Assisted with the installation, tuning, and archiving of data, while utilizing programming skills to develop necessary scripts.
- Primary Liaison & Stakeholder Communication: Served as the main point of contact between Epic Clinical Systems teams and both internal and external customers.
- Relationship Management & Collaboration: Fostered and maintained strong relationships with internal customers and project teams to ensure smooth project execution.
- Resource Management & Project Support: Mobilized resources to deliver Epic Clinical Systems services, ensuring timely support for project deliverables.
- Production Support & Troubleshooting: Provided advanced support by monitoring, troubleshooting, configuring, and enhancing systems to meet user needs.
- System Deployment & Implementation: Planned and executed the implementation of new applications or system integrations, including testing and deployment.
- Technology Design & Consulting: Researched, recommended, and designed new technologies, offering consulting advice on system capabilities and best practices.
- Mission-Driven Execution: Performed responsibilities in alignment with the organization's mission, values, and service standards, ensuring consistency in service delivery.
Research Triage Analyst
UnitedHealth Group
Maryland Heights, Missouri
05.2021 - 10.2024
- Comprehensive Research & Data Analysis: Conducted thorough investigations into member grievances from various sources, ensuring precision and accuracy throughout the process.
- Collaborative Problem Solving: Coordinated cross-departmental efforts with Appeals and Grievance teams, providing strategic responses to complex issues for the benefit of members and providers.
- Effective Communication & Stakeholder Engagement: Presented findings and insights to internal teams, promoting clear and effective information exchange to support informed decision-making.
- Active Engagement in Policy Development & Process Optimization: Contributed valuable insights in meetings related to policy decisions and process improvement projects, driving operational efficiency.
- Adherence to Regulatory & Compliance Standards: Ensured strict compliance with state and federal regulations, reimbursement protocols, and contractual obligations, maintaining the organization's commitment to ethical and legal practices.
Senior Clinical Administrative Coordinator
UnitedHealth Group
Maryland Heights, Missouri
01.2020 - 05.2021
- Initial Triage & Administrative Management: Lead the initial triage of members and manage administrative intake processes, ensuring accurate admission and discharge documentation for seamless transitions of care.
- Collaboration with Hospitals & Clinical Teams: Establish and maintain strong partnerships with hospitals and clinical teams to facilitate the efficient exchange of patient information and enhance care coordination.
- Incoming Calls & Service Requests Management: Efficiently handle incoming calls and service requests from providers and members, offering detailed guidance on network services and directing cases to appropriate clinical personnel.
- Referrals & Prior Authorizations: Oversee the referrals process, managing both inbound and outbound referrals and prior authorizations to optimize healthcare workflow efficiency.
- Intake & Record Management: Play a key role in intake, notifications, and census functions, ensuring the accuracy and organization of records to support informed decision-making and operational effectiveness.
Quality of Care Clinical Administrative Coordinator
UnitedHealth Group
Maryland Heights, Missouri
03.2017 - 01.2020
- Expertise in Document Management: Delivering healthcare providers and the quality of care, nurses demonstrate expertise in executing tasks such as the meticulous faxing of documents, judicious emailing of critical information, and the systematic ordering of essential medical charts.
Provider Data Analyst
Centene Corporation
Town & County, Missouri
03.2016 - 03.2017
- Provider Enrollment Management: Led the accurate and seamless enrollment of providers and practitioners into the provider data management system, ensuring up-to-date and precise information.
- Profile Updates & Data Accuracy: Maintained and updated provider and practitioner profiles, integrating claims payment and directory details to ensure data consistency and reliability.
- Research & System Enhancements: Conducted in-depth research and reviews based on provider requests, implementing necessary updates to enhance system functionality and efficiency.
- Quality Assurance & Data Integrity: Performed rigorous quality checks on claims processing and provider directory data, proactively identifying and correcting discrepancies to maintain system integrity.
Code Violation Specialist
CitiMortgage, Inc.
O'Fallon, Missouri
06.2013 - 03.2016
- Loan Status Evaluation & Property Research: Assessed loan statuses and conducted in-depth research on properties and local ordinances to support informed decision-making on necessary actions.
- Collaboration with Officials & Stakeholders: Engaged with code enforcement officers, city officials, attorneys, and vendors/contractors to facilitate the resolution of code violations.
- Regulatory Compliance & Hearings Participation: Represented the organization in code violation hearings, working closely with local counsel to ensure strict adherence to regulatory guidelines and compliance.
Foreclosure Research Specialist VA Bid Desk
CitiMortgage, Inc.
O'Fallon, Missouri
08.2011 - 06.2013
- Property Valuation & Foreclosure Bidding: Utilized advanced EA tools to accurately assess property values, ensuring precise foreclosure bidding instructions were communicated to attorneys.
- Foreclosure Sale Reporting & Custody Transfers: Generated detailed reports on foreclosure sale outcomes and custody transfers using the Valeri system, enhancing transparency and accountability.
- Pipeline & Foreclosure Management: Efficiently managed a high-volume pipeline, coordinating timely postponements of foreclosure sales and leveraging SCRA website insights for strategic decision-making.
Foreclosure Research Specialist, Charge off Team
CitiMortgage, Inc.
O'Fallon, Missouri
08.2010 - 08.2011
- Freddie Mac Charge-Off Collaboration: Led collaborative efforts with Freddie Mac charge-offs, meticulously validating supporting documentation for properties with compromised valuations or damage.
- Risk Assessment & Strategic Recommendations: Provided expert risk assessments and well-informed recommendations to investors and management, demonstrating deep business insight.
- Equity Analysis & Default Loan Resolution: Conducted rigorous equity analysis of defaulted loans, advising on the most cost-effective and strategic resolution pathways.
Service Processor 1 Associate
CitiMortgage, Inc.
O'Fallon, Missouri
08.2010 - 08.2011
- Customer File Integration & Document Preparation: Managed customer file requests by efficiently ordering, preparing, and scanning documents into FileNet and NLS systems.
- Audit Support & Research Efficiency: Utilized FileNet’s capabilities to expedite research for multiple audits, consistently achieving a strict 24-hour turnaround time.
- Document Sorting & Warehouse Integration: Applied precise sorting techniques using the sorting wheel to optimize document organization and seamless warehouse integration.
Education
Fort Zumwalt North High School
MO05.2006
Saint Charles Community College
MOSkills
- Comprehensive Research & Analysis
- Effective Cross-Functional Collaboration
- Meticulous Attention to Detail
- Accurate Data Insights
- Clear & Seamless Communication
- Process Optimization & Enhancement
- Operational Excellence & Efficiency
- Data Validation & Integrity Management
- Ethical Compliance & Professional Integrity
- Workflow Streamlining & Automation
- Records & Information Management
- Adaptability & Cross-Functional Agility
- Clinical & Provider Support
- Provider Credentialing & Enrollment
- Regulatory Compliance & Code Enforcement
- Foreclosure Research & Analysis
- Strategic Decision Support
- Data Integrity
- Service Processing & Workflow Management
- File Integration & Document Control
- Document Preparation & Quality Assurance
- Risk Assessment & Mitigation
- Policy Development & Refinement
- Continuous Coaching & Professional Development
Certification
Available upon request.
Timeline
Senior Business Solutions Analyst - EPIC
Mercy Technology Services
10.2024 - Current
Research Triage Analyst
UnitedHealth Group
05.2021 - 10.2024
Senior Clinical Administrative Coordinator
UnitedHealth Group
01.2020 - 05.2021
Quality of Care Clinical Administrative Coordinator
UnitedHealth Group
03.2017 - 01.2020
Provider Data Analyst
Centene Corporation
03.2016 - 03.2017
Code Violation Specialist
CitiMortgage, Inc.
06.2013 - 03.2016
Foreclosure Research Specialist VA Bid Desk
CitiMortgage, Inc.
08.2011 - 06.2013
Foreclosure Research Specialist, Charge off Team
CitiMortgage, Inc.
08.2010 - 08.2011
Service Processor 1 Associate
CitiMortgage, Inc.
08.2010 - 08.2011
Fort Zumwalt North High School
Saint Charles Community College
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