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Click here or scroll down to respond to this candidateCandidate's Name
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ObjectiveTo secure a position with a company where I can utilize my administration service skills and interested in a challenging position with room for advancement.EXPERIENCE2006-2017 AETNA HEALTH CARE Tampa, FloridaWC INTEGRATED SVC ASSOC-Under local operation supervision, responsible for processing work in a specific unit, including but not limited to front end, Provider Customer Service, Client Customer Service, or other operation groups/areas. Processes work to allow for reporting on a weekly and monthly basis. Post Capture Indexing (PCI, GB CORRESPONDS, RDI, GCI) function gives the user the ability to research missing and/or insufficient information to match medical bills to claim/injury record, using demographic notes from the image, Field Automation Case Tracking System called Facts. In using this tool (FACTS) allows us to do the searching for referral number on the document, email, attachments associated with works compensation claims.Utilization review is a safeguard against unnecessary and inappropriate medical care. It allows health care providers to review patient care from the perspective of medical necessity, quality of care, appropriateness of decision making, place of service, and length of hospital stay. I will prepare document for the department in Pre Authorization Representative know as (PAR), Contact Providers office and insurance Carriers to obtain information needed for processing of claims. Utilizing multiple software program such as Advancer,, Coventry Connect, Workflow and Risks-Facts, Working on a tight deadline providing both quality of Documents EDUCATIONRobinson High Tampa Florida High School GraduatedTampa College Development Center Tampa Florida Data Entry SKILLS10-key by touch WorkflowCoventry Connect Case Tracking System ( FACTS)Keyboard skills AdvancerCustomer Service Risk-Facts |
