Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic
Zujey D Ashbaugh

Zujey D Ashbaugh

San Antonio,TX

Summary

Detail-oriented professional with a strong background in overseeing contract lifecycles and ensuring compliance. Experienced in negotiation, document preparation, and maintaining meticulous records. Seeking a challenging role in the medical field to utilize skills, abilities, and experience to contribute to a progressive company and advance career. Consistently delivering impactful results as a Professional Referral Specialist by coordinating referrals, navigating complex systems, and ensuring seamless communication between parties. Demonstrates a focus on team collaboration, adaptability, problem-solving skills, and reliability to achieve desired outcomes.

Overview

8
8
years of professional experience

Work History

Lead Contract Coordinator

Superior HealthPlan
11.2018 - 10.2024
  • Distributing daily work
  • Responsible for creating Professional, Ancillary, and Behavioral contracts for Non Participating providers
  • Guiding our providers through their credentialing
  • Managed Chows and Choms for the whole credentialing department
  • Wellcare loads
  • LMHA BH Inbox and Load Providers to be processed for credentialing
  • Answering providers regarding their rates and routing to a network negotiator
  • Work Projects for SNF/NF facilities
  • Training new employees in our tasks

Program Coordinator

Superior HealthPlan
07.2017 - 11.2018
  • I am attaching the medical clinical for one hour promptly
  • Averaging 80-90 clinical daily
  • Processing web authorizations and verifying COBS
  • Maintaining an overall quality score of 95% or more excellent, with an error rate of
  • I was answering a high volume of inbound calls to create an authorization for Medicare via phone
  • I was assisting other departments with Medicare questions

Referral Specialist

Superior HealthPlan
07.2016 - 07.2017
  • Assuring effective use of medical resources through processing authorizations
  • Initiating authorization requests for inpatient and outpatient services and routing them to the appropriate CRNs and OBPCs
  • Verifying eligibility and benefits
  • I was answering heavy inbound calls in a queue
  • Data entry work: Enter authorization in our system manually

Education

High School Diploma -

James Monroe High School
North Hills, CA
01.2001

Skills

  • Contract drafting
  • Document Review
  • Foreign languages
  • Project management
  • Computer skills
  • Data analysis
  • Problem-solving
  • Communication
  • Teamwork
  • Time management
  • Attention to detail
  • Creativity
  • Regulatory knowledge
  • Collaboration

Languages

English
Full Professional
Spanish
Full Professional

Timeline

Lead Contract Coordinator

Superior HealthPlan
11.2018 - 10.2024

Program Coordinator

Superior HealthPlan
07.2017 - 11.2018

Referral Specialist

Superior HealthPlan
07.2016 - 07.2017

High School Diploma -

James Monroe High School
Zujey D Ashbaugh