Vanesa Diaz is seeking a permanent position where she can make significant contributions. She has over 10 years of experience in insurance claims processing and management. Her experience includes working as an Appeals Specialist managing insurance accounts receivable reports and filing appeals for denied claims. Prior experience also includes roles as a Claims Specialist reviewing claims to ensure accurate payment, a Claims Call Center Team Leader overseeing call center representatives, and a Marketing Support Supervisor supervising queue support staff.

1. Vanesa Diaz
813-998-5020 diazvanesa581@gmail 19135 US HWY 19 N. Clearwater FL 33764
Objective
Seeking a permanent position in which I may make a significant contribution to
the overall success of an organization.
Experience
Appeals Specialist- March 13, 2016 to present
Managing insurance accounts receivable reports.
Status insurance claims for all unpaid charges
File appeals or reconsiderations for all denied services and under paid claims. Work with
billing software applications to help identify and correct errors as necessary.
Explanation of benefits claim management
CLAIM SPECIALIST, PRESTIGE HEALTH CHOICE — 2011- PRESENT
Responsible for the review and validation of claims processed to ensure claims are
paid in a timely fashion, at the correct contracted or non-contracted rate.
Auditing of Physician and Facility claims for payment and benefit accuracy to
identify and communicating claim issues.
Responsible for checking AHCA's web site for new physician and facilities fee
schedules.
CLAIMS CALL CENTER TEAM LEADER, CITRUS HEALTH CARE INC. — 2008-2011
Oversee call center representatives who interface with providers via telephone,
internet or written correspondence in relations to claims processing and payment.
Analyze and adjust claim to resolve outstanding issues to achieve customer
satisfaction; using systemic approach in solving problems.
Monitor and manage workload to ensure resources meet work volume and
performance standards.

2. MARKETING SUPPORT SUPERVISOR, CITRUS HEALTH CARE — 2004-2008
Supervised queue support representatives activities. Created staff schedules and
completed evaluation of personnel performance.
Provided initial and on-going training to all queue support staff and was
responsible of notification of changes to corporate policies and procedures.
IOU MARKETING REPRESENTATIVE, AMERIGROUP — 2001-2003
Assisted prospective members with enrollment and health insurance information.
Maintained relationships with prospective members during and after open
enrollment periods.
Education
Hillsborough Community College-
Skills
Microsoft Office(Excel, Power Point, Word, Outlook, Publisher.) Amisys System,
Pegasys, Facets and Jiva.
Languages -Spanish(verbal and written)
References
Furnished Upon Request