Ashli combs

• Coordinated provider calendars and optimized patient flow in fast-paced specialty clinic settings.

• Processed patient payments at point of service, collected copays, and clarified financial responsibility for patients.

• Supported insurance eligibility checks and obtained prior authorizations for high-volume specialty procedures, reducing claim denials.

• Assisted revenue cycle efforts by submitting and tracking medical claims to speed provider reimbursement and reduce outstanding accounts receivable.

• Maintained HIPAA-compliant EMR records to ensure data integrity and uphold patient privacy.

Coordinated scheduling and administrative intake for specialized Autism, ADHD, and comprehensive psychological assessments, ensuring efficient patient flow.

Verified complex behavioral health insurance benefits and processed prior authorizations, facilitating timely access to necessary services.

• Billing Operations: Submitted claims, reviewed insurance responses, and proactively resolved billing discrepancies to ensure accurate reimbursement.

Managed patient payments and resolved complex client inquiries regarding insurance coverage and out-of-pocket costs, enhancing patient satisfaction.

• Remote-Ready Operations: Delivered high-quality, high-volume telephone and digital support to educate members on complex benefits, claims, and coverage limits.
• Resolved Aetna member inquiries regarding benefits and claims to ensure understanding and satisfaction.
• Guided members in navigating provider searches and addressing network-related questions to enhance access to care.
• Claim Adjustments: Evaluated ICD-10/CPT discrepancies, explained detailed Explanation of Benefits (EOBs), and processed timely claim adjustments.
• Ensured compliance with HIPAA regulations while discussing sensitive member information to protect privacy.