ASHLEY FOSTER
Fort Mill
Summary
Skilled claims processing professional with extensive experience in reviewing and validating insurance claims. Strong focus on accuracy, problem-solving, and effective communication. Known for collaborative approach and adaptability to changing needs. Proficient in claims software, data entry, and customer service. Recognized for reliability and achieving results in team environments.
Overview
12
12
years of professional experience
Work History
Emergency Dispatch
Concentrix
11.2023 - 10.2024
- Answered emergency calls with urgency for onstar members who needed police, fire/EMT
- Tracked locations of members on the map and figured out what cross streets they were located by giving street names, cities, or by latitude and longitude
- Sent out roadside assistance
- Unlocked car doors from crm system
- Made decisions on how to handle the call in an efficient manner
- Worked with local police, firefighters, and EMS across the United States and Canada to assist called in emergencies
- Gave out EMD instructions to callers in critical situations until help arrived
- Multitask of data entry and gathering information of the scene from callers.
Claims Appeal Specialist
Optim Healthcare
06.2020 - 08.2023
- Company Overview: Remote
- Proficiently processed claims and appeals for Optum United Healthcare, ensuring accuracy and compliance with industry standards
- Utilized CRM software to access and manage patient information, streamlining the claims resolution process
- Demonstrated expertise in medical coding, contributing to precise and efficient claim submissions and appeals
- Applied knowledge of billing procedures to enhance accuracy and completeness in claim processing
- Developed proficiency in Medicaid procedures, contributing to successful resolution of Medicaid-related claims
- Collaborated with cross-functional teams to address complex claim issues, showcasing strong teamwork and communication skills.
- Consistently met deadlines and quality requirements.
Community Health Worker
Kepro
02.2021 - 07.2023
- Company Overview: Remote
- As a Community Health Worker I am an advocate of the Community
- Contributed to COVID–19 prevention efforts in the community
- Organized and supported COVID vaccine drive-through testing and vaccination sites
- Established ongoing partnerships with local businesses for COVID-related support
- Engaged with individuals affected by COVID, offering assistance and guidance
- Met quarterly quotas on business and community engagements
- Remote
Patient Service Representative
Talent Bridge
10.2018 - 01.2020
- Handled 50 incoming calls daily, enrolling members in prescription programs
- Processed applications for approval or denial
- Addressed member inquiries regarding insurance benefits
- Managed claims and pre-certifications for medical procedures
- Handled outbound calls to members letting them know of claim status and answer questions
- Seasonal /contract position on and off
- Assisted members through chat and email
- Looked up CPT codes for benefits
Cashier
Walmart
11.2012 - 01.2018
- Scanned and bagged items at the register
- Utilized the POS system for credit card and cash payments from customers
- Maintained organization at the register
Education
Certification in Community Health -
Robeson Community College
CPR Certification -
School or University
Emergency Medical Dispatch Certification -
IAED
Charlotte, NC07.2024
Diploma -
Weddington High School
Matthews, NC06.2010
Skills
- Active listening
- Communication
- Attentive to details
- Time management
- Decision making
- Typing
- Technical support
- Team player
- CPT-Coding
- Medical terminology
- Microsoft office
- Customer service
Websites
Summary
Dedicated and experienced professional seeking a role to utilize my skills in community engagement., Authorized to work in the US for any employer
Timeline
Emergency Dispatch
Concentrix
11.2023 - 10.2024
Community Health Worker
Kepro
02.2021 - 07.2023
Claims Appeal Specialist
Optim Healthcare
06.2020 - 08.2023
Patient Service Representative
Talent Bridge
10.2018 - 01.2020
Cashier
Walmart
11.2012 - 01.2018
CPR Certification -
School or University
Emergency Medical Dispatch Certification -
IAED
Diploma -
Weddington High School
Certification in Community Health -
Robeson Community College
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