Open to opportunities

Julissa Jaquez

@julissajaquez

Message

Bilingual operations professional driving provider relations, client support, and claim/workflow problem resolution.

United States

Message

What I'm looking for

I’m looking for operations roles supporting client and provider workflows across Latin America, the Caribbean, and the U.S. I bring bilingual communication, provider contracting/relations, and claims-billing-authorization resolution in remote environments.

I’m a bilingual operations professional supporting administrative operations, documentation management, scheduling, inbox support, and remote coordination. I combine clear client communication with provider relations to keep workflows moving and records accurate.

In my current provider relations role, I coordinate Single Case Agreements for out-of-network providers and maintain provider records and contract data in Salesforce and QNXT. I track contract activity and follow-ups with Excel and support onboarding by partnering with credentialing, contracting, operations, and provider teams.

Across remote and client-facing operations, I’ve managed scheduling, vendor communication, digital records, and task tracking—while supporting multiple clients with strong follow-through. I’ve also handled claims, billing, authorization, denial review, insurance verification, and issue resolution that impact provider operations and service delivery.

I bring a clinical documentation improvement mindset from reviewing provider documentation for CDI initiatives and assessing records related to HCC risk adjustment and coding accuracy. Previously, I supported high-volume scheduling and patient inquiries, including 70+ visits daily and 200+ monthly inquiries, and I verified insurance eligibility to support accurate billing and claims processing.

Experience

Work history, roles, and key accomplishments

Current

Provider Relations Representative

Current

Hamaspik Choice

Jun 2025 - Present (1 year 1 month)

Coordinated Single Case Agreements for out-of-network providers and supported provider onboarding/relationship maintenance. Maintained provider records and contract data in Salesforce and QNXT and supported issue resolution related to claims, billing, authorization, and provider data.

Provider Relations Provider Contracting Single Case Agreements Rate Negotiation Support Salesforce QNXT Excel Provider Data Management Claims Follow Up Billing Support Authorization Provider Onboarding Documentation Management Issue Resolution Spanish Bilingual English

Remote Operations Coordinator

La Connect NYC

Sep 2019 - Jun 2025 (5 years 9 months)

Provided remote administrative and operations support, including scheduling, inbox management, documentation, and workflow coordination. Managed vendor communication, client follow-ups, task tracking, and organization of digital records and operational documents.

Remote Operations Administrative Operations client support Scheduling Documentation Management Workflow Coordination Calendar Management Spanish Bilingual English

Provider Consultant

Second Wave Delivery Systems

Apr 2023 - Jun 2024 (1 year 2 months)

Supported Clinical Documentation Improvement by reviewing provider documentation and identifying documentation gaps. Created Excel tracking reports and coordinated provider outreach, documentation requests, and follow-ups in collaboration with coding, quality, and provider relations teams.

Clinical Documentation Improvement (CDI)Documentation Review HCC Risk Adjustment Coding Accuracy Reimbursement Quality Provider Outreach Excel reporting Provider Relations Cross Functional Collaboration Spanish Bilingual English

Patient Experience Specialist

Sono Bello

Mar 2022 - Apr 2023 (1 year 1 month)

Managed front desk and patient experience workflows, including scheduling accuracy for pre-operative and post-operative appointments. Handled patient inquiries and prepared daily operational, scheduling, and financial reports for clinical and administrative teams.

Patient Experience Front Desk Operations Scheduling Appointment Management Post Operative Appointments client support inquiry handling Billing Support Operational Reporting Financial Reporting

Medical Billing & Scheduling Coordinator

Plastic Surgery of New York

Nov 2017 - Jan 2020 (2 years 2 months)

Coordinated surgical scheduling across multiple surgeons and procedures while maintaining EMR records and surgical documentation. Verified insurance eligibility, supported billing and pre-authorization workflows, and worked with teams to resolve scheduling, billing, insurance, and workflow issues, including ICD-10 coding.

Surgical Scheduling EMR Insurance Eligibility Verification Billing Support ICD 10 Patient Communication Spanish Bilingual English

Insurance Verification Representative

BluePearl Veterinary Partners

Sep 2014 - Jul 2017 (2 years 10 months)

Verified insurance eligibility, coverage details, and authorization requirements to support accurate billing and claims processing. Processed claims, reviewed denied claims, coordinated appeals/follow-up actions, and communicated with insurance carriers regarding claim status and documentation needs.

Insurance Verification Authorization Claims Processing Appeals Coordination Documentation Requirements Spanish Bilingual English