Ashley Edwards

Las Vegas, NV *****

ad1ozp@r.postjobfree.com

+1-702-***-****

Accomplished professional with over 15 + years experience as a healthcare billing specialist and customer service representative. I am seeking a position to utilize my strong leadership, communication, interpersonal skills and actively contribute to the growth and well-being of your company.

Authorized to work in the US for any employer

Work Experience

Insurance Billing and Reimbursement Specialist

Professional Billing Solutions LLC - Henderson, NV April 2021 to Present

• Submission of all billing, commercial insurance, MCOs, HMOs, charge entry

• Insurance eligibility verification and patient out of network cost estimates

• Corrected claim submission with the appropriate CPT/ ICD-10 codes, modifiers, POS, TOS, and authorization

• Rebilled claims not on file or lost by insurance and submitted substantiating documentation

• Appeals submission to overturn denied or short paid claims Medical Billing and Collections Specialist

Medical Revenue Solutions - Las Vegas, NV

September 2019 to March 2021

• Responsible for managing accurate and timely completion and submission of all charges

• Submission of commercial insurance, MCOs, HMOs, and patient billing

• Worked directly with the insurance company, healthcare provider, and patient to get a claim processed and paid

• Resolved clearinghouse rejections and denials

• Verified patient accounts for creating payment plan or pre-collections process CSR - Customer Service Representative/Cashier

Bed Bath & Beyond - Las Vegas, NV

July 2017 to August 2019

• Assisted customers with checkout, answered outstanding questions

• Solved billing issues and answered customer inquiries

• Assisted customers with product inquiries, refunds and exchanges, maintaining excellent customer satisfaction rate

Denial Management Specialist

Las Vegas Skin and Cancer Clinic - Henderson, NV

March 2015 to June 2017

• Managed a high volume of claims meeting productivity levels

• Insurance audits on underpaid, overpaid claims with recoupments/ offsets

• Reviewed each insurance payment EOB for accuracy and compliance with contract discount

• Communicated with insurance companies regarding any discrepancy in payments

• Completed and submitted corrected claims and appeals on unpaid accounts Medical Biller/Collector

Heart Center of Nevada - Las Vegas, NV

May 2010 to January 2015

• Entered CPT codes and patient information into billing software

• Reviewed and validated accuracy of charges including dates of service, services provided, location, and authorization

• Worked claims and claim denials to ensure maximum reimbursement for services rendered

• Appeals submission to overturn denied or short paid claims

• Utilized billing software to process financial eligibility, authorization, billing, and denial follow-up transactions

• Posted insurance and patient payments

• Reviewed patient bills for accuracy and obtained missing information prior to generating patient statements

• Communicated with patients to help them understand the reasons for their bill Customer Service Associate/Cashier

Toys 'R' Us - Las Vegas, NV

June 2007 to April 2010

• Conducted sales transactions, processed payments, and managed cash register with zero discrepancies

• Maintain a friendly and welcoming attitude, providing excellent customer service

• Resolve customer complaints with a 97% satisfaction rate Cashier/Customer Service Representative

Walmart - Las Vegas, NV

March 2005 to June 2007

• Processed transactions to date with 100% accuracy, handling cash, credit card, and electronic payments

• Responsible for a balanced cash drawer at the opening and closing of a shift

• Resolve customer complaints and provide expert knowledge regarding products Education

Certified Medical Billing Specialist (CMBS) in Medical Billing & Coding Nevada Career Institute

June 2007 to February 2008

High school diploma

C O Bastian High School - Caliente, NV

August 2004 to June 2005

Skills

• Customer service

• Leadership

• Negotiation

• Data entry

• Patient care

• Communication skills

• Decision-making

• CPT coding

• ICD-10

• Medical terminology

• Insurance verification

• Prior authorization

• Cash register

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