Ashley Mitchell

Results-driven healthcare professional with 7+ years of experience in prior authorization, insurance verification, and revenue cycle operations. Skilled in navigating payer requirements, securing timely authorizations, preventing denials, and supporting commercial, Medicare, Medicaid, and managed care plans. Adept at ensuring HIPAA compliance, resolving complex insurance issues, and collaborating with providers, patients, and insurance carriers to deliver accurate, efficient service in high-volume healthcare environments.

Prior Authorization Specialist - Hummingbird Healthcare - Remote, GA

(2024-08 - 2026-07)

• Prioritize incoming prior-authorization and pre-certification requests according to department policies and workflows.
• Contact health plans to verify active coverage, benefits, and authorization requirements.
• Work directly with facilities and Account Management to obtain required clinical documentation.
• Submit the necessary information to health plans to ensure authorization requirements are met.
• Follow up on pending cases and escalate cases when additional assistance is needed.
• Make and receive calls with healthcare professionals, insurance carriers, and manufacturer representatives.
• Maintain accurate and timely case notes and database entries.
• Refer requests requiring clinical judgment to the appropriate supervisor.
• Meet required turnaround times and productivity metrics while managing a full caseload.

Case Manager - Cencora - Remote, GA

(2020-10 - 2024-08)

• Managed patient cases from intake through resolution, coordinating services, follow-up activities, and timely resolution of patient and customer support needs.
• Performed insurance verification and benefits investigations, reviewing eligibility, coverage, plan requirements, limitations, and patient responsibility to support access to prescribed therapies and services.
• Coordinated prior authorizations, coverage reviews, appeals, and insurance-related documentation, working with payers, providers, pharmacies, and internal teams to resolve coverage barriers.
• Conducted comprehensive case intake, assessment, documentation, and follow-up, ensuring accurate and timely updates throughout the case lifecycle.
• Managed assigned caseloads while prioritizing urgent requests, unresolved exceptions, time sensitive authorizations, and cases requiring additional intervention.
• Supported patient access initiatives by helping patients navigate insurance requirements, coverage restrictions, financial assistance resources, and available support programs.

Patient Transporter - Atrium Health - Macon, GA

(2018-05 - 2020-10)

• Transport patients safely between departments, rooms, diagnostic areas, and other locations within the hospital.
• Use wheelchairs, stretchers, beds, and other approved transport equipment.
• Assist patients with getting on and off transport equipment while maintaining their dignity, comfort, and safety.
• Communicate professionally with patients, families, nurses, physicians, and other hospital staff.
• Follow infection-control, patient-safety, and hospital procedures.
• Verify patient identification and transport destinations before moving patients.
• Report changes in a patient's condition or safety concerns to the appropriate clinical staff.
• Provide compassionate customer service, especially to patients who may be anxious, uncomfortable, or have limited mobility.

High School Diploma - Miller-Motte Technical College