Ashlie Graham
Medical Billing And Collections
Salt Lake City,UT
Summary
Objectives Highly experienced Medical Collector seeks a position of increased responsibility and tasks. With very strong attention to detail and extensive knowledge of medical reimbursement. Detail-oriented Insurance Specialist versed in researching and resolving complex issues on behalf of policyholders, companies and carriers. Bringing sixteen years of expertise with insurance claim processing. Gifted in working with stressed, confused and upset individuals in need of benefits information and supportive guidance to navigate their care within the health plan industry.
Overview
15
15
years of professional experience
4
4
years of post-secondary education
Work History
Sr. Appeal Specialist
Health Choice Utah
Salt Lake City, United States
04.2021 - 08.2022
- Resolved appeals and grievances for each health plan Health Choice Generations Medicare Advantage and Health Choice Utah Medicaid
- Reviewed outstanding requests and redirected workloads to complete projects on time
- Communicated effectively with staff members of operations, finance and clinical departments.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Developed appeals functions, policies and procedures and documentation.
- Created, composed and maintained appeal response templates.
- Acted as a departmental resource on appeal and grievance matters.
- Maintained a strong knowledge of CMS compliance guidelines for both appeals and grievances.
- Conducted research, gathered information from multiple sources and presented results
- Worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately
- Led projects and analyzed data to identify opportunities for improvement
Reimbursement Senior Collector
BYRAM
MURRAY, UT
04.2012 - 04.2021
- Created spreadsheets using Microsoft Excel for daily, weekly and monthly reporting
- Thoroughly investigated past due claims and minimize number of unpaid DME claims
- Learned new skills and applied to daily tasks to improve efficiency and productivity
- Created plans and communicated deadlines to complete projects on time
- Used critical thinking to break down problems, evaluate solutions and make decisions
- Actively listened to customers' requests, confirming full understanding before addressing concerns
- Carried out day-to-day duties accurately and efficiently
- Prepared variety of different written communications, reports and documents
- Developed team communications and information for meetings
- Increased customer satisfaction by resolving issues
Medical Insurance Collector
Medical Professions
Murray, UT
10.2011 - 04.2012
- Collected on physician and DME oxygen claims
- Performed full-cycle medical billing in a fast-paced medical billing company
- Resolved billing issues, found trends with payers, and appealed denied claims.
- Executed billing tasks and recorded information in company databases
- Completed and processed purchase orders and customer invoices each quarter
- Followed up with appropriate parties to obtain prompt payments
Collector
University of Utah
, UT
08.2007 - 06.2011
- Meticulously tracked and resolved facility claims for the University of Utah hospital, clinics, and Huntsman Cancer Center
- Resolved conflicts and negotiated mutually beneficial agreements between parties
- Collaborated with team members to achieve target results
- Proved successful working within tight deadlines and fast-paced atmosphere
- Created spreadsheets using Microsoft Excel for daily, weekly and monthly reporting
- Resolved problems, improved operations and provided exceptional service
Education
Medical Assistance Certification -
Salt Lake Community College
01.2009 - 01.2010
Highschool diploma -
Brighton Highschool
2220 E 7695 S 01.2003 - 01.2006
Skills
Policy interpretation
undefinedTimeline
Sr. Appeal Specialist
Health Choice Utah
04.2021 - 08.2022
Reimbursement Senior Collector
BYRAM
04.2012 - 04.2021
Medical Insurance Collector
Medical Professions
10.2011 - 04.2012
Medical Assistance Certification -
Salt Lake Community College
01.2009 - 01.2010
Collector
University of Utah
08.2007 - 06.2011
Highschool diploma -
Brighton Highschool
01.2003 - 01.2006
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