Julissa Casanas

813-***-****

acsu8i@r.postjobfree.com

Experience

Service Operation Specialist

Aetna (formally Coventry HealthCare) Tampa, FL

Responsible for one or more aspects of service including, processing claims, adjustments, enrollment and eligibility records, reporting receipt of client files, responding to customer inquiries, and resolving customer concerns. Process claims, enrollments, and/or adjustments in accordance with company policies and procedures in a timely manner. Monitor account receivables records including claims and overdue invoices; implement collection procedures.

Preauthorization Representative

Coventry HealthCare Tampa, FL

Responsible for data entry, processing referrals for services including DME, physical therapy, inpatient and outpatient care, behavioral health services, and special circumstance requests as defined by Utilization Management. Perform telephonic support for on-line authorization of routine services. Provide direct support to primary care practices, specialty care providers, and insurance adjusters regarding utilization, authorization, and referral activities. Assist in gathering information needed for coordinators/case managers to determine continued authorization.

2013 to 2014

2004 to 2012

Data Processor

Concentra Managed Care Tampa, FL

Responsible for data entry, scanning and processing medical bills ensuring invoice is billed accurately and accordingly to the services rendered.

2004 - 2004

Education

Liberty University

Bachelor’s of Science in Psychology w/ a minor in Life Coaching

Insurance Coding & Billing/Data Processing

2013-Present

2003 - 2004

Concorde Career Institute, Tampa, FL

Diploma

H.B. Plant High School, Tampa, FL

2000

*Proficient in Spanish

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