Ashley Kimble

Redford, MI *****

ad219x@r.postjobfree.com

+1-517-***-****

Willing to relocate: Anywhere

Authorized to work in the US for any employer

Work Experience

Customer Service Representative

Delta Dental - Farmington Hills, MI

October 2023 to Present

• Enters and adjusts claims

• Promptly and professionally responds to member, client and provider questions through multiple channels, including, but not limited to telephone, email, fax and U.S. mail communication using proper etiquette, grammar, punctuation, etc. • Clearly and accurately communicates all eligibility, benefit, claim status and payment information related to caller’s questions • Properly identifies the reason(s) for the call and provides appropriate resolution to inquiries and complaints within specified timeframes and guidelines established by regulatory agencies or client contracts. • Informs and assists callers with grievance and the claims appeals processes, as necessary • Clearly, accurately and thoroughly documents information in the customer relationship management system to ensure all relevant details of the phone call are captured. • Understands the importance of adhering to regulatory requirements • Meets or exceeds quality standards as required for position • Meets or exceeds call center metrics as required for position

Customer Service Representative

Robert Half - Troy, MI

January 2022 to July 2023

• Act as a liaison, provide product/services information, answer questions, and resolve any emerging problems that our customer accounts might face with accuracy and efficiency

• Respond to telephone and/or Internet inquiries from customers seeking information and/or resources, following a set standard.

• Process insurance claims.

• Interpret customer policies and coverages.

• Negotiate settlements.

• Authorize payments.

• Maintain customer records.

• Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.

• Responsible for initiating the research on the appeal/grievance Patient Access Representative

The University of Michigan - Ann Arbor, MI

May 2021 to February 2023

• Provide check-in and check-out support for all patients. Deliver exceptional customer service to patients and families in a fast-paced clinic environment. Responsibilities include: appointment and test scheduling

• Scheduling of cardiac catheterizations echocardiograms,EKG and stress test for in-office and hospital procedures

• Prior Authorizations - Prior authorization of cardiac catheterization, echocardiograms, and nuclear stress testing.

• Collected, posted, and managed patient account payments.

• Submitted claims to insurance.

• Prepared and review patient statements.

• Reviewed delinquent accounts and call for collection purposes.

• Processed payments from insurance companies.

• Maintained strict confidentiality.

Receptionist/Administrative Assistant

Trinity Health - Ann Arbor, MI

January 2018 to July 2021

Welcome patients by greeting and helping them, scheduling appointments, and maintaining records and accounts. Welcomes patients and visitors in person or on the telephone, and answering or referring inquiries. experience in office practices & procedures as well as in public relations and customer service. I have developed excellent communication skills and techniques for handling difficult costumers. experience in typing, keyboarding, data entry or word processing as well as using epic and excel. Able to type 40 WPM. Able to provide use of personal computer. Perform claims integrity by researching and identifying insurance information for the member Verify patient/claimant information, the payer network, in- or out-of-network status, research any/all information to determine coverage levels- to include calling insurance providers or accounts when necessary Calculate deductibles, out of pocket costs, and copays Provide updates on any/all benefits investigations related to the member’s financial responsibility (such as co-pays, co-insurance) Perform order entry – update records with complete patient and insurance information

Medical Assistant

Henry Ford Health System - West Bloomfield Township, MI November 2018 to May 2021

Part time employment-Answer and make phone calls to schedule patients for procedures. Answer any and all questions a patient may have. as well as set up sterile tray and draw up medication needed for procedure. assist radiologist during procedure with patient. Track and order specimens texting order by radiologist. Call patient and or ordering physician with results of procedure in a timely manner. Education

CNA,Phlebotomy,EKG,PCT in Medical

Michigan Medical Academy of Emergency Services - Jackson, MI 2014 to 2014

High School Diploma in General

Columbia Central High School - Brooklyn, MI

2005 to 2009

Skills

• Receptionist

• Medical Records

• Office Experience

• Epic

• EMR Systems

• Medical Scheduling

• Hospital Experience

• Insurance Verification

• Clerical Experience

• Microsoft Office (10+ years)

• Medical Terminology

• Medical Coding

• Office Management

• Medical receptionist

• Communication skills

• Customer service

• Organizational skills

• Medical Billing

• HIPAA

• ICD-10

• Phone Etiquette

Certifications and Licenses

CNA, pct,EKG, phlebotomy

2014 to 2020

Certified Nursing Assistant (CNA)

CPR/First Aid

CPR

Certified Clinical Medical Assistant (CCMA)

Additional Information

Experience and trained in front desk administrative. Claims, appeals, denial and authorizations. scheduling, completion of medication prior authorizations forms. Experience with electronic medical records. Epic and Facet experience.

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