Summary
Overview
Work History
Education
Skills
Timeline
Generic

Jennifer Ashwood

Grievance Appeals Specialist

Summary

Experienced Insurance appeals Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering Over 15 years of experience and willingness to take on any challenge.

Overview

18
18
years of professional experience

Work History

Appeals Specialist

Quadax
Middleburg Heights , Ohio
06.2019 - Current
  • Responded to attorney inquiries and litigation notices.
  • Created, composed and maintained appeal response templates.
  • Coordinated with client to compose appeal responses.
  • Developed appeals functions, policies and procedures, and documentation.
  • Acted as a departmental resource on appeals matters.
  • Checked documentation for accuracy and validity.
  • Generated, posted and attached information to claim files.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Calculated adjustments, prepare appeal for payment disputes.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Maintained confidentiality of patient finances, records and health statuses.
  • Modified, updated and processed existing policies.
  • Actively seeks information to understand clients' circumstances, expectations and needs
  • Provide consistent quality service to clients/patients
  • Effectively monitors clients' concerns, issues and satisfaction.



Manager

TGI Fridays
Brooklyn , OH
06.2013 - 04.2019
  • Accomplished multiple tasks within established timeframes.
  • Onboarded new employees with training and new hire documentation.
  • Cross-trained existing employees to maximize team agility and performance.
  • Maximized performance by monitoring daily activities and mentoring team members.


  • Adjusted job assignments and schedules to keep pace with dynamic business needs, factoring in processes, employee knowledge and customer demands.
  • Developed and maintained relationships with customers and suppliers through account development.
  • Established and updated work schedules to account for changing staff levels and expected workloads.
  • Approved regular payroll submissions for employees.
  • Applied customer feedback to develop process improvements and support long-term business needs.
  • Raised performance in areas of sales, management and operations by identifying and targeting areas in need of improvement.
  • Conducted monthly inventories of raw materials and components on work floor.
  • Achieved or exceeded financial goals on regular basis by controlling expenses, optimizing schedules and regulating inventory usage.
  • Kept alcoholic beverages well-stocked and organized to meet expected demands.
  • Strategized plans to increase bar revenue through innovative promotional concepts, specialty drinks and customer-focused events.
  • Adhered to state laws regarding alcoholic beverage services and customer regulations.
  • Consulted with managers to organize special events and promotions.
  • Designed special drink and cocktail offerings on monthly basis as part of seasonal offerings.
  • Motivated and disciplined employees and implemented new mentoring program, which increased worker morale.
  • Assisted servers with specialty drinks orders by preparing on-demand items without delay.
  • Decreased waste, following strict recipes and drink measurement protocol.


Customer Service Specialist

Exacta Land Surveyors
Cleveland, OH
05.2009 - 06.2011
  • Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
  • Took payment information and other pertinent information such as addresses and phone numbers to place orders.
  • Applied basic sales strategy to engage customers and present solutions to suit individual needs.
  • Surpassed performance goals by approaching interactions with resourcefulness, organization and customer-centric solutions.
  • Coordinated schedules for optimal coverage of daily workload and adjusted quickly to changing demands.
  • Received new orders, prepared documentation and assigned personnel.
  • Monitored flow of paperwork and directed information to appropriate departments.
  • Facilitated communications between customers and field personnel to answer questions or resolve concerns.
  • Served as mediator when appropriate to settle conflicts and discrepancies between field personnel and management.

Skip Tracer

Xpress Loan Servicing
Cleveland , OH
08.2006 - 05.2009
  • Identified best-known address to locate client's collateral or customer.
  • Made daily collection calls to customers.
  • Proactively monitored accounts and addressed various issues.
  • Searched computer databases, credit reports, public records or other resources to locate persons or to compile information for investigations.
  • Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
  • Maintained energy and enthusiasm in fast-paced environment.
  • Negotiated to collect balance in full.
  • Used probing techniques to determine debtors' reasons for delinquency.
  • Researched accounts and completed due diligence to resolve collection problems.
  • Used skip tracing and other techniques to locate debtors.

Underwriter

Family Heritage Life Insurance
North Royalton, OH
05.2002 - 05.2006
  • Supported review and acceptance or denial of new or renewal business.
  • Reviewed applications for insurance coverage and reports from loss control specialists to determine risks.
  • Calculated group and individual renewal rates based on customers background, industry and demographic information.
  • Proved successful working within tight deadlines and fast-paced atmosphere.
  • Used critical thinking to break down problems, evaluate solutions and make decisions.
  • Liaised with customers, management and sales team to better understand customer needs and recommend appropriate solutions.

Education

No Degree - Paralegal Studies

Cuyahoga Community College
Cleveland

High School Diploma -

St Joseph Academy
Cleveland, OH
06.2000

Skills

  • Diversified customer service professional
  • Self Motivated
  • Efficient and organized
  • Strong analytical skills and attention to detail
  • Excellent communication skills
  • comfortable multitasking
  • Able to assess client needs and provide solutions
  • Able to communicate effectively with diverse populations of clients and all levels of personnel
  • Demonstrate accountability by exceeding goals and expectations, consistent records of promotion
  • Exceptional work ethic, committed to continuous improvement

Timeline

Appeals Specialist

Quadax
06.2019 - Current

Manager

TGI Fridays
06.2013 - 04.2019

Customer Service Specialist

Exacta Land Surveyors
05.2009 - 06.2011

Skip Tracer

Xpress Loan Servicing
08.2006 - 05.2009

Underwriter

Family Heritage Life Insurance
05.2002 - 05.2006

No Degree - Paralegal Studies

Cuyahoga Community College

High School Diploma -

St Joseph Academy

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Jennifer AshwoodGrievance Appeals Specialist