Marla Wolfe
Winter Haven,FL
Summary
In 2023 I retired after almost 27 years of service with Aetna. I miss it. I would like to work for the company again. I am available to start as of March 15, 2024.
Overview
27
27
years of professional experience
Work History
Multiple
CVS Aetna
Winter Haven, FL
03.1997 - 11.2023
- Senior Analyst - Reconciling shared accumulators for members who are receiving benefits for more then one vendor. Example Aetna medical and Caremark Rx. This requires research into many possible scenarios including but not limited to plan set up and eligibility.
- ACAS claims analyst - Process medical, hospital, rework, and projects for the ACAS platform. Participated in answering questions for experienced and new processors.
- CCR Analyst - Review medical notes and policy to determine if provider appeal request meet criteria for nurse review. Send out letter to the provider explaining Aetna policy and medical guidelines if that do not.
- Employer contact - Served as an employer contact for claims issues as well as possible plan set up issues.
- HMO claims analyst - Processed medical, hospital, and rework claims on HMO platformed. Participated in training experienced processors.
- HMO customer service - Handled inbound calls from providers and members in regards to HMO claims and benefits.
Education
High School Diploma -
Osbourn Park High School
Manassas, VA06-1992
Skills
HMO and ACAS
- Analytical
- Interpersonal Communication
- Training & Development
- Customer Service
- Attention to Detail
Accomplishments
- I received an Aetna Way award in approximately 2015 or 2016. I was nominated for assisting with trainees in answering their questions and preparing to be claims analyst.
Timeline
Multiple
CVS Aetna
03.1997 - 11.2023
High School Diploma -
Osbourn Park High School