Ashley Richter
Hopkins,South Carolina
Summary
Dedicated Customer Advocate Representative providing skills to prioritize and multi-task in a fast-paced working environment. I successfully work as part of a team to reach personal and business goals. I am also known for successfully handling escalated situations that may require immediate attention. At this time, I am seeking a challenging position in a reputed organization where I can learn new skills, expand my knowledge and leverage my learnings.
Overview
12
12
years of professional experience
Work History
Claim Representative
Cigna-Evernorth
05.2023 - Current
- Perform full review of claim codes and correct any identified data errors or inconsistencies
- Perform comprehensive reviews of documentation within the health record to accurately assign ICD CM codes for diagnosis and complications, and CPT/HCPCS codes for surgeries, procedures, evaluation and management services, and inpatient professional services
- Review provider health record documentation to ensure that it supports diagnostic and procedural codes assigned, and is consistent with required medical coding nomenclature
- Use various computer applications to abstract records, assign codes, and record and transmit data
Underwriter Support Analyst
Mutual Of Omaha
05.2018 - 04.2023
- Served as the first point of contact for producers and policyholders for life and health insurance.
- Conducted risk analysis and help producers and policyholders understand the requirements needed to finish the underwriting process
- Empathetically listened to Financial Professionals and their clients concerns, providing emotional support during challenging situations, and offered solutions that meet their current and future needs
Benefits Verification Specialist
Capital Blue Cross
09.2014 - 04.2018
- Directly consulted with members and patients regarding their medical, dental, and vision health benefits via incoming calls
- Directly consulted with the clinical staff for clarification of conflicting, incomplete, or ambiguous clinical data in the health record via incoming or outgoing calls
- Helped the claim examiners code all complicated and complex medical/specialty diseases processes, patient injuries, and all medical procedures in a wide range of ambulatory/inpatient settings and specialties
- Assisted agents with handling calls and took over escalated concerns to deliver expert solutions
Customer Resolution Specialist
U S Bank
12.2012 - 09.2014
- Provided customer service and resolution to inquiries received via incoming and outbound calls.
- Performed portfolio analysis to identify trends in borrower performance.
- Prepared reports summarizing findings from underwriting reviews, risk assessments and analyses
Education
High School Diploma -
Lockport Township High School
Lockport, IL06.2012
Skills
- Conflict resolution
- Calm and professional under pressure
- Problem solver
- Verbal and written communication
- Courteous with strong service mindset
- Empathetic and compassionate
- Excellent analytical and organizational skills
- Attention to detail
Timeline
Claim Representative
Cigna-Evernorth
05.2023 - Current
Underwriter Support Analyst
Mutual Of Omaha
05.2018 - 04.2023
Benefits Verification Specialist
Capital Blue Cross
09.2014 - 04.2018
Customer Resolution Specialist
U S Bank
12.2012 - 09.2014
High School Diploma -
Lockport Township High School