Ashley Stafford
Lewisville,Texas
Summary
Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.
Overview
11
11
years of professional experience
Work History
Life Insurance Advocate
Transamerica
05.2022 - 06.2023
- Use exceptional customer service and interpersonal skills to answer calls regarding retirement products such as 401k, IRA's and 403(b) investments.
- Identify customer needs and provide personalized service to ensure positive and meaningful outcomes; engage more knowledgeable team members as needed.
- Locate/research information using multiple systems/technologies.
- Coordinate with cross-functional departments to obtain and/or provide necessary information to resolve issues.
- Document customer inquiries and associated actions; follow-up on outstanding items in a timely manner.
Auto Claims Adjuster
Amynta Warranty Group
08.2020 - 02.2022
- Researches, documents and recaps coverage and loss information; could include comprehensive and complex calls
- Communicates over the phone to ensure understanding of reports and documents
- Performs an evaluation of the loss to determine potential total losses using established procedures
- Interprets statutes and case laws to build a strong case for coverage and liability.
- Files subrogation claims in Arbitration Forums with persuasive arguments
- Provides prompt, friendly, courteous, accurate, and helpful service including information about the claim handling process, claim number, name of adjuster, and general questions about existing claims
- Effectively follows appropriate process for assignment of claims to adjusters.
Medical Record Specialist
MRO Corporation
09.2017 - 05.2020
- Determines records to be released by reviewing requestors information in accordance with HIPAA guidelines and obtaining pertinent patient data from various sources, including electronic, off-site, or physical records that match patient request.
- Answer phone calls concerning various customer issues.
- If necessary, responds and processes requests from physician offices on a priority basis and faxes information to the physician office.
- Logs medical record requests into company' database.
- Complies with site facility policies and regulations.
- At specified sites, responsible for handling and recording cash payments for requests
Patient Advocate
UnitedHealth Care Group
03.2012 - 01.2017
- Verifies insurance eligibility and benefits on all assigned accounts using electronic verification systems or by contacting payers directly to determine level of insurance coverage. When contacting payers directly, utilizes approved scripting.
- Identifies outstanding balances from patient’s previous visits and attempts to collect any amount due.
- Functions as a Superuser for primary computer systems.
- Works on Special Projects as needed
- Prior Authorization investigation.
- Maintains up-to-date knowledge of specific admission, registration, and pre-authorization requirements for all areas.
Education
High School -
Venture High School
Arlington, TXundefined
Volunteer
Girls Inc of Tarrant County
Arlington, Ashley, Stafford, TX2010
Skills
- Claims File Management Processes
- Database Management
- Insurance Policy Coverage Knowledge
- Litigation Resolution
- Claims Negotiation
Timeline
Life Insurance Advocate
Transamerica
05.2022 - 06.2023
Auto Claims Adjuster
Amynta Warranty Group
08.2020 - 02.2022
Medical Record Specialist
MRO Corporation
09.2017 - 05.2020
Patient Advocate
UnitedHealth Care Group
03.2012 - 01.2017
High School -
Venture High School
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Volunteer
Girls Inc of Tarrant County