Kathleen E Ashley
Clover,USA
Summary
Managerial professional with proven record of streamlining processes and leading high-performing teams. Known for strong analytical skills and commitment to achieving results. Teams rely on collaborative leadership and adaptability to changing needs.
Overview
28
28
years of professional experience
Work History
Manager, Risk Management & Accreditation
Cencora formally AmerisourceBergen
05.2022 - 11.2024
- Supervise team of 3 Document Management Specialists and oversee daily activities
- Facilitate weekly team meetings, Bi-weekly 1v1s, Quarterly Focus Check-ins, Yearly Performance Reviews
- Identify process improvements related to document management and quality initiatives
- Create and manage process documents for SmartSolve Admin and User References
- Manage Self-Audit process for 100+ programs
- Facilitate meetings with program senior leadership to review results of Self-Audit, identify gaps, and perform effectiveness checks
Document Management and Governance Specialist
AmerisourceBergen
07.2016 - 05.2022
- Acts a Super User for document management system (IQVIA SmartSolve) utilized by the Governance Risk & Compliance (GRC) team, including:
- Creation and maintenance of user, including roles and right within the system
- Creation of routine and ad hoc reports
- Managing documents in the system
- Training
- Liaison with Lash Group/ABC document owners to support good document management practices
- Liaison with Premier Source to support ongoing quality initiatives
- Support annual SSAE audit for Premier Source
- Identify process improvements related to document management and quality initiatives
Premier Source Remittance Specialist
AmerisourceBergen
11.2013 - 07.2016
- Loading electronic 835 files into Work Queue
- Posting of payments, adjustments and recoupments
- Setting up claims for appeals when appropriate
- Creating notes and tasks in Work Queue
- Reviewing incoming correspondence
- Completion of write-off requests
- Applying unapplied payments to appropriate cases
- Updating and balancing of monthly remittance tracker
- Retrieving RA’s from various websites
- Contacting insurance companies to clarify information on EOB’s
- Month End Reconciliation Client Reports
- Creating SOPs
- Author of Remittance Tracker used across all programs
- Member of SOP Work Group
- Provide Remittance Administrator support to all team members across various programs
- Pilgrim Migration Project Lead
- Facilitator of Document Management and Pilgrim Migration Project Training
Billing Specialist
Preferred Primary Care Physicians
03.2008 - 01.2011
- Specialized in Blue Cross and Blue Shield Products
- Retrieving and processing of weekly remittance file
- Daily submission of all Blue Cross claims
- Review and correction of all Blue Cross rejected claims
- Corresponding with Office Managers to correct billing errors
- Taking incoming patient calls
- Charge entry for Flu Clinic
Collections Specialist
Pediatric Alliance, P.C.
03.2007 - 03.2008
- Daily Posting Personal Patient Payments
- Generating Bank Deposits and making daily deposits directly to the bank
- Sending Weekly Patient Statements
- Running Weekly Collections Report
- Sending Collection Letters (i.e
- Bad Debt, Precollect, Discharge)
- Making/Taking Patient Calls Related to Past Due Balances
- Sending Patient Accounts to Outside Collection Agency
- Setting Up Payment Plans
- Corresponding with Office Managers on Delinquent Accounts
- Corresponding with Collection Agency on Collection Accounts
Billing Coordinator II
Quest Diagnostics Incorporated
11.2005 - 03.2007
- Posting Client Payments
- Follow Up with Clients on Missing Payments, Over Payments and Short Payments
- Client Collections
- Completing Client Billing Change Requests
- Completing Client Refund Requests
Billing Mix Coordinator
Quest Diagnostics Incorporated
06.2004 - 11.2005
- Research Missing Billing Information (i.e
- ICD-9 codes and insurance information)
- Contacting Clients for Missing Billing Information
- Contacting Patients for Missing Billing Information
- Pulling Down Daily Work from the Access Database and Assigning Daily Work
Billing Coordinator II
Quest Diagnostics Incorporated
05.1997 - 06.2004
- Complete ‘All Carrier Eligibility Match’ List
- Working Weekly Department Rejection Lists from Insurance Carriers
- Complete All Incoming Correspondence
- Back-up for Printing Weekly Reports for Staff
- Developed SOPs for all Insurance Internet Sites for eligibility, claim status and reviews
- Recipient of “Our Best” award May 2004
Education
Diploma - Sports Management: Fitness and Nutrition
California University of Pennsylvania
California, Pennsylvania05.2011
Diploma -
Mount Lebanon Senior High
Pittsburgh, Pennsylvania06.1995
Skills
- IQVIA SmartSolve
- Microsoft Office
- Microsoft Visio
- Microsoft Teams
- SharePoint
- Cross-functional collaboration
- Teamwork and collaboration
- Adaptability and flexibility
- Prioritizing and planning
- Team management
- Team building
- Recruitment and hiring
- Staff training
- Process implementation
Timeline
Manager, Risk Management & Accreditation
Cencora formally AmerisourceBergen
05.2022 - 11.2024
Document Management and Governance Specialist
AmerisourceBergen
07.2016 - 05.2022
Premier Source Remittance Specialist
AmerisourceBergen
11.2013 - 07.2016
Billing Specialist
Preferred Primary Care Physicians
03.2008 - 01.2011
Collections Specialist
Pediatric Alliance, P.C.
03.2007 - 03.2008
Billing Coordinator II
Quest Diagnostics Incorporated
11.2005 - 03.2007
Billing Mix Coordinator
Quest Diagnostics Incorporated
06.2004 - 11.2005
Billing Coordinator II
Quest Diagnostics Incorporated
05.1997 - 06.2004
Diploma -
Mount Lebanon Senior High
Diploma - Sports Management: Fitness and Nutrition
California University of Pennsylvania
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