Stephanie Ashford
Palmdale, CA *3550
Summary: A detailed-oriented professional with experience in the health
care and social services industry. Major strengths include: Windows 2010,
PowerPoint, Microsoft Word, Excel, AS400, Virtual Chart, Sandis, Medical
Terminology, Law Enforcement Terminology, Knowledge of EPO/POS/PPO
policies, Knowledge of HIPAA/JCAHO/NCQA/URAC standards, Type 65-75 wpm,
excellent communication, writing and interpersonal skills.
Education:
California State University Long Beach, California
Masters of Science in Healthcare Administration (12/2007)
California State University Long Beach, California
Bachelors of Science in Healthcare Administration (05/2004)
University of Southern California, Los Angeles, California
Nursing Program Candidate, Health Science Campus (08/1998-01/2000)
Life, Accident, & Health License (01/2014)
Experience:
AC Hospice, Inc. 12/13 to
present
Director of Operations/Assistant Administrator
. Supervise Personnel/Disciplinary Action of employees
. Oversee Operations of all Hospice Services
. Employee Orientation/In-Service Trainings
. Ensuring JCAHO compliance/ Internal audit compliance/ Chart Review
. Grievance and Incident Reporting
. Organizational Billing/Health Plan coordination/Check Benefits and
Eligibility
. DME Contract Negotiations and other supplies
. IDT Meetings/ Collaboration with all disciplines regarding patient
care
. Field Visits/ Track Certifications of Terminal Illness reports
Molina Healthcare of Long Beach 08/12 to
12/12
Utilization Management Coordinator (Contract)
. Obtains appropriate information for authorization request entry/claims
processing/DRG
. Requests clinical records per procedure.
. Accurately applies appropriate policies, procedures, and stop loss,
eligibility, and benefit policies/PDR
. Refers requests and notifications to appropriately licensed health
professional for review.
. Accurately documents all activities as per policy including entry into
automated systems.
. Interacts with the providers or members as appropriate to communicate
approval outcomes in compliance with state, federal and accreditation
requirements.
. Performs hospital notification functions.
. Reports suspected fraud and abuse as per company policy.
. Performs required clerical support duties.
. Maintains confidentiality of all PHI in compliance with state and
federal law and Health Net Policy.
Anaheim Adult Day Care, Anaheim, California 05/10
to 05/11
Program Director (Non-Profit/Behavioral Management Program)
. Knowledge of Title 17 and 22 requirements/Regional Center policies
. Recruit, employ, evaluate, supervise, and train staff/Reconcile
Payroll
. Coordinate job development and Consumer Employment/Interviews
. Maintain communication with care providers and families/Maintain
Client Census
. Maintain employee files/Attend Semi-annual and Annual meetings
. Process referral packets and Conduct In-service Trainings/Community
Resources
. Audit Personnel and Client Charts/Generate Data Collection Materials
and Life Skills Training Materials
. Review and document all Special Incidents
. Develop and write behavior intervention plans/Intake Assessments
Fresenius Medical Care, Van Nuys, California 10/09 to
05/10
Financial Coordinator
. Explores, recommends, and coordinates the varied financial assistance
options available to FMS kidney dialysis patients/Counseling Patients
. Provided Financial Waivers and Grants through the American Kidney
Foundation
. Ensure the provision of the best financial resources possible for each
patient in the assigned clinics while maximizing revenue for the
company
. Collaboration with Social Security Office, Medi-Cal, Medicare, COBRA
Administrators, and Commercial/Private Insurances
. Applies policies and procedures of stop loss, benefits and eligibility
appropriately
. Occasional Travel as needed
Los Angeles County Sheriff's Department, Monterey Park, California
05/08 to 09/08
Deputy Sheriff Trainee
. Academy instruction in department policies and procedures
. Defense Tactics
. Criminal and civil law concepts
. Physical fitness techniques
. Use of firearms, arrest procedures
. Operation of emergency vehicles
South Central Los Angeles Regional Center, Los Angeles, California
5/06 to 05/08
Case Worker/Service Coordinator (Non-Profit/Social Services)
. Good client interview skills/Case Management-Special Needs/ Report
Writing-IPPs
. Request Funding-POS Authorizations/ Caseload of 91 families
. Clinical/Social Agency Knowledge/ Attending IEPs and ISP meetings
. Knowledgeable of Conservatorship, Disability laws and Lanterman Act
. Community Relations/ Initiating Interdisciplinary Teams/Client
Advocacy
. Extensive interaction with Program Managers, Vendors, Behaviorist, and
Specialists
. Initiate Special Incident Reporting, Coordinate Services/Community
Resources
. Occasional Travel as needed
Prospect Medical Group, Santa Ana, California
3/06 to 5/06
Data Analyst
. Responsible for collecting, analyzing, and reporting data related to
operational metrics.
. Creates databases to track operational performance
. Develops and analyzes operational performance reports (e.g., for
claims data, provider data, utilization data)
. Collects and analyzes data to create summary statistics of performance
. Creates and publishes periodic reports as well as any necessary ad hoc
reports
. Performs other duties as assigned.
United Healthcare, Long Beach, California
10/02 to 5/04
Intake Notification Coordinator
. Pre-approved outpatient and inpatient medical services, discharge
planning, quoted benefits/eligibility, adjusted claims, resolved claim
issues, complaints/ICD-9/HCPC Coding and liaison between utilization
review and providers.
. Administrative support, benefit/policy/stop loss education, claims
processing, DRG, PDR, securing patient confidentiality.
Managed Health Network, Los Angeles, California
10/00 to 12/01
Intake Specialist
. Authorized behavioral health services, resolved client and provider
complaints.
Pre-certified outpatient and inpatient services, assisted in quality
improvement and generated explanation of benefits, claims
adjustments/processing, DRG, provider negotiations of single case
agreements, quoted benefits/stop loss/eligibility coverage, PDR, and
training and acted as assistant supervisor.
References:
Available upon request