Ashley Williams
Covington,GA
Summary
Business-minded Analyst with exemplary skills in customer service, time management and communication. Bringing over 14 years of related experience combined with compiling, coding, categorizing and auditing information to process claims.
Overview
4
4
years of professional experience
Work History
Clinical Appeals Analyst
HCA Healthcare Parallon
02.2022 - Current
- Review medical insurance claims
- Generate and follow-up on all appeals based on the dispute reason & contract terms specific to the payor
- Resolve Coding Issues
- Escalate exhausted appeal efforts for resolution
- Research contract terms & compile supporting documentation
- Make determination of corrective action plans & take appropriate steps to code system and route accordingly.
- Overcome objections that prevent payment & gain commitment through concise and factual collection skills.
- Report overpayments & underpayment irregularities
- Perform trend tracking
- Processed approximately 35 claims daily
Human Resources Onboarding Specialist
Accenture Solutions
10.2021 - 09.2022
- Utilize applicant tracking system (APS), customer relationship management tools (CRM), and queue management platform for recruiting qualified candidates.
- Conduct outbound calls, generate emails/text messages to send to applicants in their pre-boarding & onboarding stage to prepare for orientation.
- Put together employee files and collected required digital or physical information to meet requirements.
- Coordinated pre-employment screenings, background checks, and documentation requirements to expedite hiring timelines and reduce potential delays in bringing talent onboard.
- Facilitated open lines of communication between new hires and their supervisors, fostering a positive and inclusive work environment from day one.
Lead Claims Adjudicator
Maximus
10.2020 - 09.2021
- Define the scope of information pertinent to & supporting the application for benefits; Develop strategies to obtain information.
- Read & analyze employment -related files received, comparing objective findings from differing sources.
- Analyze insurance activity reports & Reduced errors through diligent review of state & federal regulations, policies and thorough investigation of claims.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Articulated legal binding decisions on complex & sensitive issues such as exceptions & evidence of admissibility through written documentation.
- Conducted regular audits on completed claims to identify areas for improvement and implement corrective measures as needed.
- Consistently met or exceeded weekly performance targets for claims processing and adjudication, contributing to overall departmental success.
Education
Bachelor of Science - Health Information Management
Ultimate Medical Academy - Clearwater
Clearwater, FLSkills
- Verbal & Written Communication
- Decision-Making / Problem Solving
- Critical Thinking
- Autonomous
- Time Management
- Database Management
- EMR Systems
- Medical Terminology
- Microsoft Office Suite
- SaaS
- UB04 Forms
- HCPCS & CPT Codes
Timeline
Clinical Appeals Analyst
HCA Healthcare Parallon
02.2022 - Current
Human Resources Onboarding Specialist
Accenture Solutions
10.2021 - 09.2022
Lead Claims Adjudicator
Maximus
10.2020 - 09.2021
Bachelor of Science - Health Information Management
Ultimate Medical Academy - Clearwater
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