Ashley Nielson Email & Phone Number

• Assisted with development and implementation of Inpatient Authorization process by working directly with consultants and management to identifying solutions and processes.
• Developed, implemented, and updated current guidelines and procedures as appropriate.
• Provided, Collected, and created reports for direct management and Directors to highlight discrepancies and provide solutions.
• Created training programs, resources and tools for colleagues and Team members.
• Mentored Teammates to help achieve team goals and to ensure the highest level of efficiency.
• Managed authorizations, denials, and special requests, from health insurance and case managers to impact Revenue Cycle

Sacramento, California, United States

· Assigned and delegated work to specialists and representatives based on priority, volume, and workflow· Provided coaching, feedback, support, and training to all Team Members. · Onboarded new employees and assisted with Requesting access for systems and provided training. · Assisted with Technical issues when applicable. · Used independent judgement to.

Sacramento, California Area

• Analyzed and interpreted medical guidelines to determine if appropriate information has been provided prior to sending reviews to external contracted payers.
• Identified any missing information or needed necessary information on utilization reviews and escalates to Nurse or operational support representative for needed correction.
• Forwarded completed and error free Utilization reviews to correct payer.
• Responded to Payer communication requests and followed departmental procedures to route requests appropriately.
• Understood urgency and effectively worked with Care Coordination team to complete a high level of processed reviews in a timely manner.
• Completed special requests to process urgent reviews in addition to completing daily worklist.

Rancho Cordova, CA

• Scheduled veterans for medical appointments
• Regularly resolved escalations from the VA and network providers
• Processed medical documents and screening paperwork for proper documentation
• Called various providers to schedule appointments
• Performed an average of 40 authorizations per day in different specialties of care
• Provider liaison for specialty care

Sacramento, CA

• Provided customer service via phone by assisting patients with fulfilling medical equipment orders. On average 60-70 orders processed per day.
• Obtained clinical information needed for processing orders. Including: HCPCS codes, ICD10 codes, oxygen saturation levels, and more.
• Verified insurance information and eligibility by confirming insurance plan(s), deductible status, out of pocket expenses
• Requested authorizations for medical equipment from insurance companies
• Suggested process improvements implemented by management for order processing optimization
• Coached trainees and colleagues on how to more effectively perform job duties

Rocklin, California

• Provided excellent customer service over the phone assisting members with daily financial needs. Average call volume: 80 calls per day. Average handle time: 4½ minutes.
• Built and leveraged relationships with multiple departments to help better assist members
• Assisted members with setting up online banking via multiple platforms, such as mobile and web.
• Effectively offered multiple financial products to our membership base
• Processed consumer loan payments

Sacramento, CA

Received 50 to 70 calls per day and maintaining a low average handle time while providing a high level of customer satisfaction and retention, cross- selling business products and services. Overcoming customers banking concerns which may include: escalated issues missing deposits, cerdit or debit card issues, files claims ect..

Health Informaton Technology

Acitvely pursuing a degree in Health Information Technology.

Diploma, General Studies