Ashley M.

About Ashley M.

Experienced healthcare specialist with solid background in credentialing and licensingoperations and regulatory compliance. Detail-oriented individual with exceptionalcommunication and project management skills. Proven ability to handle multiple taskseffectively and efficiently in fast-paced environments. Recognized for taking aproactive approach to identifying and addressing issues, with focus on optimizingprocesses and supporting team objectives.\"We are what we repeatedly do. Excellence, then, is not an act, but a habit.\"- Aristotle

Experience

1. Account Care Educator

   AssistRx

   Sep 2025 — Present · Dallas-Fort Worth, TX, US

   Managed claim queues and maintained organized records in a fast-paced environment. • Ensured compliance with industry regulations by staying updated on prescription plans and billing policies. • Interacted with healthcare providers and internal teams to resolve claim inquiries and gather necessary information. • Utilized medical billing and EHR software to accurately process claims and maintain records.• Analyze claims for accuracy based on insurance coverage, cost of goods, allowable amounts, and copays.• Promptly report reimbursement changes, underpayments, pricing discrepancies, or cost assistance needs.• Monitor profitability of orders, manage claim queues (e.g, 3 & 5, 541, B queues), and adjust last events accordingly.• Troubleshoot rejected claims and process prior authorizations or overrides.• Perform daily reconciliation of batch postings, including automated/manual claim inputs.• Coordinate with the Financial Assistance Department for additional funding when necessary.• Processes medical copay claims in accordance with program business rules.

Education

• King's College

  Associate of Science - AS, Business Administration and Management, General

  2001 — 2002

• Strayer University

  Health Services Administration

  2016 — 2018