Open to opportunities

ashley young

@ashleyyoung2

Message

I resolve complex provider payment disputes across Medicare, Medicaid, and commercial claims.

United States

Message

At Reliant, I resolve post-payment provider disputes involving reimbursement, coding, authorization, and payment discrepancies. I research claim history, EOP/EOBs, billing details, and Medicare reimbursement requirements while negotiating Single Case Agreements.

Previously at Optum Healthcare, Kaiser Permanente, and Cigna, I handled provider appeals, claims processing, healthcare operations, and process improvement across Medicare Advantage, Medicaid/Medi-Cal, and commercial claims.

Experience

Work history, roles, and key accomplishments

Post-Payment Claims & Medicare Reimbursement Specialist

Reliant

Resolved provider appeals and post-payment disputes involving reimbursement, coding, authorization, and payment discrepancies. Researched claim history, EOP/EOB documentation, billing details, and DRG, UCR, ASP, SNF, ambulance, behavioral health, and Medicare reimbursement requirements.