Ashley Tijerina
Joliet,IL
Summary
Detail-oriented and CRCR-certified insurance professional with over 9 years of experience in healthcare claims, insurance collections, appeals, COB letters, and patient account adjustments. Proficient in Epic, payor portals, and MS Office. Known for accuracy, reliability, and strong interpersonal communication.
Overview
10
10
years of professional experience
Work History
Claims Adjuster
Annuity Health
08.2024 - Current
- Analyze and adjust insurance claims in accordance with policy guidelines
- Investigate discrepancies and process corrections or adjustments
- Work with payers to resolve underpayments or denials
- Communicate with providers and patients regarding claim outcomes
- Maintain accurate documentation and timely follow-up on all accounts
Insurance Representative
Ensemble Health Partners
02.2022 - 08.2024
- Adjusted patient accounts and submitted appeals for denied or underpaid claims
- Filed corrected claims using payer portals and EPIC
- Prepared and sent COB (Coordination of Benefits) letters to insurers
- Utilized EPIC for claims workflow and patient account review
- CRCR Certified; ensured compliance with industry standards
- Daily use of Microsoft Outlook, Word, Excel
Medical Receptionist
Premier Dermatology
07.2017 - 07.2021
- Verified insurance eligibility and processed referrals
- Scheduled patient appointments and dermatologic procedures
- Maintained patient charts using EHR and EMA systems
- Ensured HIPAA compliance in all patient interactions
Lead Referral Specialist / Receptionist
Pain Specialist of Greater Chicago
02.2016 - 08.2016
- Verified insurance and processed referrals
- Reviewed and coded claims using ICD-10
- Scheduled procedures and managed front-desk workflow
Administrative Assistant
State Farm
04.2015 - 10.2015
- Handled policy changes and processed homeowner quotes
- Provided customer support for inbound/outbound calls
- Processed payments and managed account documentation
Education
Business Law, Microsoft Office
Joliet Junior College
01.2006
High School Diploma -
Plainfield Central High School
01.2005
Skills
- Insurance Claims & Appeals
- EPIC System, EHR, EMA
- COB Letter Processing
- MS Office (Outlook, Word, Excel)
- ICD-10 Familiarity
- HIPAA Compliance
- Account Adjustments
- Time Management & Multitasking
- Strong Interpersonal Communication
- Benefits verification
Claims Specialist | Insurance Collections | Appeals & Account Adjustments
Detail-oriented and CRCR-certified insurance professional with over 9 years of experience in healthcare claims, insurance collections, appeals, COB letters, and patient account adjustments. Proficient in EPIC, payer portals, and MS Office. Known for accuracy, reliability, and strong interpersonal communication.
Timeline
Claims Adjuster
Annuity Health
08.2024 - Current
Insurance Representative
Ensemble Health Partners
02.2022 - 08.2024
Medical Receptionist
Premier Dermatology
07.2017 - 07.2021
Lead Referral Specialist / Receptionist
Pain Specialist of Greater Chicago
02.2016 - 08.2016
Administrative Assistant
State Farm
04.2015 - 10.2015
Business Law, Microsoft Office
Joliet Junior College
High School Diploma -
Plainfield Central High School
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