1. Robert Ashby
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Objective: To I want to succeed in a stimulating and challenging environment, building
the success of the company while I experience advancement opportunities.
Experience:
May 2015- present Community Health Systems Nashville, TN
Insurance Collector
 Assess each account for balance accuracy, payer plan and financial class accuracy, billing accuracy,
denials, insurance requests, making any necessary adjustments, documenting appropriately and submits
corrections or request for processing in a timely manner.
 Resolve claim processing issues on a timely basis by reviewing claim inventories, payments and
adjustments and taking appropriate actions to ensure proper discounts and allowances have been
completes as well as identifies account for secondary billing and processes of refers to appropriate
personnel.
 Ensure accurate and complete account follow-up by demonstrating a thorough understanding of
carrier-specific reimbursement as applicable to claim processing to include: benefits and coverage
according to specific carrier, UB92 claims form preparation, 1500 claims form preparation and
interdepartmental communication necessary for timely submission of claims. Ensures all appropriate
internal collection steps have been taken.
 Work any assigned correspondence related to assigned accounts.
 Perform other required duties in a timely, professional, and accurate manner. Document all activity
taken on an account in the patient account notes.
May 2013- May 2015 Corizon Nashville, TN
Claims Examiner
 Process hospital, physician, dental and ancillary provider claims accurately based on medical
authorization and apply all applicable coding edits and contractual agreements.
 Utilizing tools such as Microdyn, Claim Check, Virtual Examiner, and QNXT review claims for potential
fraud, waste and abuse; hospital acquired conditions and never events.
 Maintain production and accuracy requirements as set forth by Claims Policy and
Procedures.
 Assist callers with answers related to prescription drug benefit plans
 Typical calls involve listening, answering questions, sharing information, describing a process,
explaining a benefit, and educating the participant
Aug 2006- March 2013 Silverscript Nashville, TN
Member Services Representative
 Assist callers with answers related to prescription drug benefit plans
 Typical calls involve listening, answering questions, sharing information, describing a process,
explaining a benefit, and educating the participant
 Other tasks will be assigned as outlined by the Supervisor as the business requires

2.  To deliver the highest quality customer service by using empathy, problem solving, pro-active
responsiveness, reliability and professionalism during every customer interaction.
 Proficiency navigating in a Windows operating system while providing assistance to participants.
 Identify plan participant's needs and advise them on appropriate solutions.
 Establish a rapport with plan participants to understand their needs while providing appropriate
solutions and efficient customer service.
 Deliver customer service through the execution of empathy, problem solving, proactive
responsiveness, reliability, assurance/confidence, and professionalism on every plan participant
interaction in a fast-paced call center environment.
Education:
2000-2005 Lane College Jackson , TN
 B.A., Business with a concentration in finance.
 Member of the Baptist Student Union.
 Member of the NAACP on campus
1996-2000 Pearl-Cohn High School Nashville , TN
 Graduated from the business magnet program
 Member of Future Business Professional of America
 Student Council Treasurer
3001 Hamilton Church Rd Unit 518 Antioch, TN 37013
615-775-0881