Jennifer Montanez
Mesa,AZ
Summary
Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Appeals Specialist
Aetna
06.2012 - 05.2017
- Developed appeals functions, policies and procedures and documentation.
- Created, composed and maintained appeal response templates.
- Responded to attorney inquiries and litigation notices.
- Acted as a departmental resource on appeals matters.
- Coordinated with senior specialist to compose appeal responses.
- Coordinated with contracting department to resolve payer issues.
- Maintained confidentiality of patient finances, records, and health statuses.
- Generated, posted and attached information to claim files.
- Verified client information by analyzing existing evidence on file.
- Processed and recorded new policies and claims.
- Determined appropriateness of payers to protect organization and minimize risk.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
Education
Associate of Applied Science - Nursing
04.2008
Skills
- Customer Satisfaction
- Claims Adjustments
- Written Communication
- Insurance Plan Verification
- Diagnostic Codes
- Standard Operating Procedures Understanding
- Filing Appeals
- Healthcare Terminology
- Patient Diagnosis
- Insurance Industry Experience
- Claims Preparation
- Policy and Procedure Explanations
- Regulatory Compliance Adherence
- Work Organizing and Prioritizing
- Data Entry Software
- Policy Requirements and Eligibility
- Prior Authorization Processing
- Insurance Coverage Limits
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Timeline
Appeals Specialist - Aetna
06.2012 - 05.2017
Broadview University - Associate of Applied Science, Nursing