Ashley M. Email & Phone Number

Receive, review, and process Short Term Disability insurance claims in accordance with company processing guidelines; Analyze medical records, reports, and forms for necessary data to support claims decisions; Communicate with claimants, employers, medical professionals regarding status and required information; Evaluate documentation to support FMLA time for employees; Update employers on subordinates’ leave status; Utilize internal communication channels to aid in processing and career development

Receive inbound calls from providers needing assistance with submitting prior authorizations for musculoskeletal services; Aid in troubleshooting portal issues by raising tickets and communicating with Tier 2 IT; Review authorization status and assist with clinical documentation submission; Submit new authorization requests from faxed forms; Upload clinical documentation; Respond to authorization requests via email; Compose correspondence needed to submit to providers regarding appointments and other inquiries; Make outbound calls for registration assistance and scheduling Peer to Peer appointments

Troubleshoot customer problems and identify solutions; Analyze detailed billing data and provide explanations to customers to ensure adequate understanding of invoices; Educate customers and position Verizon solutions to drive and close sales; Build customer relationships by earning their dedication and trust through unmatched customer experiences

San Antonio, Texas Area

Bench tech experience in Hematology, Chemistry, Donor Center Operations, Blood Bank and Transfusion Services, Microbiology, Parisitology, Immunology, and Phlebotomy.

San Antonio, Texas

Worked with Medicare recipients to understand requirements and provide exceptional pharmacy benefits service.Addressed prior authorization requests via phone, fax and mail.Consulted with healthcare professionals to determine customer eligibility. Completed request validation following CMS and company guidelines. Responded to customer requests, offering excellent support and tailored recommendations to address needs.Performed data entry with MedHOK to record call notes, suggestions and questions.Assessed caller accounts to determine Medicare Part D benefits, identify service needs and resolve issues.Met, and often exceeded, call quality measurements of call handling time, customer resolution, and after call wrap up.

Ammunitions (Air National Guard) (Storage and Accountability Shop) (January 2011-November 2013)Move weapons and ammunition in computer system from various locationsReceive incoming phone calls and direct to appropriate personnel

RAPIDS/DEERS Official (United States Navy) (November 2008 - May 2010)Processed approximately 45 identification cards and benefits applications daily with 98% accuracyAnswered inbound calls regarding benefit eligibility and services rendered at siteConducted monthly maintenance on site equipmentTyped inventory reports using Microsoft ExcelTrained 7 incoming officials on office procedures and software usageMaintained customer transaction logCompleted software updates monthly Received award from site director for top customer satisfaction

Master Of Science - Ms, Advanced Data Analytics

Bachelor Of Science - Bs, Information Science/Studies

Associate Of Science - As, Biology, General

Certificate, Clinical Laboratory Science/Medical Technology/Technologist