Hi, I’m
Ashley Ortiz Nation
Colorado Springs,United States
Summary
Experienced Accounts Receivable Specialist with 12 years of expertise in managing all accounts receivable functions in high-volume environments. Proficient in medical billing and denial management, I effectively use various computer systems, including EPIC and Point Click Care, to resolve outstanding claims proactively, which has led to a noticeable increase in collections. I possess a strong understanding of Medicare, Medicaid, and third-party payer regulations. I am seeking a position where I can apply my analytical problem-solving skills to drive revenue growth.
Overview
12
years of professional experience
Work History
Ascend Clinical
Accounts Receivable Specialist
05.2023 - Current
Job overview
- Responsible for all areas of the revenue management life cycle
- Ensures necessary information critical to submitting clean claims is obtained
- Perform eligibility and benefit checks
- Minimize bad debt by ensuring timely follow-up of unpaid claims, resolution of denials, and other payer-related correspondence
- Research, appeal, and resolve claim rejections, underpayments, and denials with the appropriate payer
- Reviews and interprets payer remittances to determine appropriate action to be taken on denied claims
- Identify root cause of claim exceptions; resolve and/or escalate issues
- Analyzes outstanding account balances and determines a plan of action to resolve
- Determine and apply appropriate business action in absence of policies or in cases of ambiguity
- Identifies and interprets policies related to exceptions
- Contacts payers for the status of unpaid claims
- Maintains knowledge/understanding of third-party payer regulations for managed care, Medicare, and Medicaid accounts
Cape Fear Valley Health System
Physician Billing Specialist
10.2020 - 05.2024
Job overview
- Follow up on outstanding A/R through working claims and phone calls to insurance companies, requesting corrected information from the clinic and/or patients
- Process secondary claims to include: researching the accounts in the EPIC system, retrieving primary EOB to attach to file the claim, checking for errors, posting activity notes, and submitting the claim to the correct insurance company
- Researching claims to make necessary corrections and submitting requested information to the insurance companies through timely follow-up
- This includes medical records requests, making adjustments, credentialing problems, posting errors, and reversals
- Complete payment tracking forms as well as refund requested when needed
- Communicating and following up with the clinics on any corrections needed (i.e., transferring charges, correcting insurance coverage, adjustments, payment reversals/and or refunds, charge corrections, etc.)
Robert Half
Accounts Receivable Consultant
12.2019 - 10.2020
Job overview
- Worked in the Physician Billing department at Cape Fear Valley as a contracted temporary agency until a permeant position was available
Soundcare Inc.
Corporate Accounts Receivable
06.2014 - 02.2020
Job overview
- Medicare Billing for 3 Skilled Nursing Facilities
- Medicaid Billing for 2 Skilled Nursing Facilities
- Insurance Billing for 2 Skilled Nursing Facilities
- Completed AR Month End close outs for all 3 Facilities
- Point of Contact for Company transition into Point Click Care system - Including Training of AR staff - Assisting in setup of new components
- Helped with Insurance Verification for all 3 facilities
- Point of Contact for Accounts Receivable Departments for all 3 facilities
- Completed Multiple DSHS Trust/AR Audits
- Helped with Front Desk Duties
University Place Care Center
Accounts Receivable Assistant
01.2013 - 06.2014
Job overview
- Medicaid/Medicare/Coinsurance Billing
- Insurance verification for incoming residents
- Daily Census Changes and Notifications
- Covering Front desk duties
- Assisting AR Manager with any other request
- Entering Ancillary Charges for Month End
- Assisting Central Supply Manager with monthly Ancillaries
Education
University of Washington Tacoma
Bachelor's degree
01.2011
Pierce College at Fort Steilacoom
Associate's degree
01.2009
Skills
- Account Reconciliation
- Medicare
- Healthcare
- Billing dispute resolution
- Adjustment posting
- Claims processing
- Medical insurance billing
- Analytical problem solving
- Insurance verification
- Accounts receivable
- Dispute resolution
- Aging reports analysis
Current Position
Accounts Receivable Specialist, Ascend Clinical, Colorado Springs, CO, 05/08/23, Present
Timeline
Accounts Receivable Specialist
Ascend Clinical
05.2023 - Current
Physician Billing Specialist
Cape Fear Valley Health System
10.2020 - 05.2024
Accounts Receivable Consultant
Robert Half
12.2019 - 10.2020
Corporate Accounts Receivable
Soundcare Inc.
06.2014 - 02.2020
Accounts Receivable Assistant
University Place Care Center
01.2013 - 06.2014
Pierce College at Fort Steilacoom
Associate's degree
University of Washington Tacoma
Bachelor's degree
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