Ashley Potts
Site Coordinator
Atlanta,GA
Summary
Intuitive Medical Insurance Specialist possessing excellent organizational, communication and multitasking abilities. Looking to leverage 10 plus years of Customer Service and experience in Claim Assessment and Benefit Verification. Track record of meeting and exceeding company goals through advanced knowledge of medical and insurance industries and terminologies, and appropriate and accurate coding with a Willingness to take on added responsibilities to help achieve company goals.
Overview
9
9
years of professional experience
Work History
Site Coordinator
AmerisourceBergen
11.2019 - Current
- AmerisourceBergen - Fort Mill, SC
- Coordinated site investigations, documented issues and escalated to executive teams
- Answered over 50 daily inbound calls, faxes and emails to resolve payment and claim discrepancies from patients, doctor's offices and insurance providers
- Ability to work from Queue and maintain individual task list of over 200 patients in faced paced environment
- Checked insurance documentation for accuracy and validity on updated systems
- Analyzed and approved patient applications for specialty medication assistance
- Triaged medication orders and coordinated deliveries with specialty pharmacies and medical offices
- Maintained Extensive knowledge of various Commercial and Medicare Policies to ensure coverage
- Checked documentation for accuracy and validity on updated systems
- Explained benefits to plan participants in easy to understand terms in order to educate each on available options
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
- Followed up on denied claims to verify timely patient payment and resolution
- Assured timely verification of insurance benefits for over 1,000 patients prior to patient procedures or appointments
- Maintained knowledge of CPT, ICD-10, and HCPC coding
- Provided Prior Authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Completed Peer Reviews for Benefit Verifications
Learning Assistant
Continuum Global Solutions
08.2019 - 11.2019
- Assists Trainers daily with facilitating lessons and role plays in classroom setting
- Monitor and document agent behaviors by providing one on one coaching
- Track and maintain attendance and personal folders for over 20 Agents
- Ensure agents are prepared for nesting period on production floor
- Facilitated student engagement and collaboration to enhance classroom learning
- Evaluated programs and monitored implementation and compliance with regulations to achieve objectives
Operations Supervisor
Continuum Global Solutions
03.2019 - 08.2019
- Establish positive rapport with managers and teammates to maintain positive and successful work environment
- Addressed and mitigated escalated situations to meet organizational objectives and drive customer satisfaction ratings
- Assisted staff with resolving complex customer issues and implementing targeted solutions
- Ensured team member performance by providing supervision, counseling and evaluations to over 20 agents
Team Lead
Continuum Global Solutions
01.2019 - 03.2019
- Facilitated daily huddles
- Developed and mentored over 100 team members to provide hospitable, professional work areas
- Reduced process gaps by effectively training new hires on best practices and protocols
- Facilitated individual coaching sessions with CSRs to realign productivity goals
- Created and offered additional materials to enhance training
- Coordinated meetings with agents' production supervisors for easy transition to production
Special Billing Office Specialist
Carolinas Medical Center
06.2016 - 01.2019
- Recovered over $100,000 in lost revenue by reaching out to patients with past due accounts
- Determined customer eligibility for benefit programs and services
- Posted charges, payments and adjustments
- Interpret Medical and Insurance Documents
- Remained up to date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs
- Meet and exceeded monthly production and profit goals of $10,000
- Follow up with Patients to obtain or release appropriate information and documents
- Researched and resolved billing discrepancies to enable accurate billing
- Collaborated with claims department and industry anti-fraud organizations to resolve claims
- Used classification manuals to gain additional knowledge of disease and diagnoses processes
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records
Customer Account Services
Continuum Global Solutions
10.2017 - 01.2019
- Act as escalation cue for customer service representatives
- Retention Specialist
- Identified and resolved customer complaints
- Data entry
- Meet and exceed monthly goals for sales and plan changes by upselling relevant products and services to over 1,000 customers
- Processed payments and maintained payment information
- Review and correct billing errors
- Provided Tier I Tech Support
Customer service Representative II
Master Media Enterprises
02.2014 - 11.2017
- Collected and Posted Payments
- Upsell Products and Services
- Increased Site sales by 10%
- Managed over 50 customer calls per day
- Provided Prayer
- Educated customers on 100s of products
- Prepared Tax Receipts for donations
- Obtained and maintained broadcasting information to maximize profits
- Provided order statuses
- Maintained Accurate Customer Records
- Met customer call guidelines for service levels, handle time and productivity
Education
BBA - Human Resources Management
Coastal Carolina University
Conway05.2016
Advanced Placement - Advanced Placement
South Pointe High School
Rock Hill, SC06.2012
No Degree - Business Management
York Technical College
Rock Hill06.2012
Skills
- Proficient in Microsoft
- Working knowledge of CPT, ICD-10, and HCPC coding
- Insurance Industry Experience
- Insurance Coverage Verification
- Collaborative Relationships
- Prior Authorization Experience
- Patient Contact
- Detail oriented
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Languages
- English
Quote
Your task is not to foresee the future, but to enable it.
Antoine de Saint-Exupéry
Timeline
Site Coordinator
AmerisourceBergen
11.2019 - Current
Learning Assistant
Continuum Global Solutions
08.2019 - 11.2019
Operations Supervisor
Continuum Global Solutions
03.2019 - 08.2019
Team Lead
Continuum Global Solutions
01.2019 - 03.2019
Customer Account Services
Continuum Global Solutions
10.2017 - 01.2019
Special Billing Office Specialist
Carolinas Medical Center
06.2016 - 01.2019
Customer service Representative II
Master Media Enterprises
02.2014 - 11.2017
BBA - Human Resources Management
Coastal Carolina University
Advanced Placement - Advanced Placement
South Pointe High School
No Degree - Business Management
York Technical College