Key Qualifications - * Proven track record of assessing benefit claims and healthcare options, including extensive knowledge of Medicare and government regulations. * Adept at developing and maintaining detailed administrative and procedural processes that significantly reduce expenses, improve accuracy and efficiency, and achieve organizational objectives. * Highly focused and results-oriented in supporting complex, deadline-driven operations identify goals and priorities and resolve issues in initial stages. * Excellent oral and written skills. * Knowledgeable in Medicare, Managed Care and PPO health plans. * Knowledgeable in claims processing, which included review of medical/routine office visits, in and outpatient hospital claims, surgical claims, anesthesia claims and durable medical equipment claims. * Extensive knowledge of medical terminology, CPT, ICD9, ICD10 and HCPC coding. * Knowledge of provider contracts, enrollment, billing and claims coding and processing. * Knowledge of medical, surgical, and behavioral health services. * Good understanding of Stop Loss insurance. * Proficient in Microsoft Office Suite, Outlook, Windows OS, and internal claims systems type 85+ wpm with complete accuracy.

Highlights:

Companies I like:

Blue Cross Blue Shield of New Jersey, Aetna Insurance Company, Horizon Blue Cross

• Benefits
• Billing
• Compensation
• Complaints
• Fraud
• Health Insurance
• Insurance
• Managed Care
• Anesthesia
• Behavioral Health
• insurance
• sales
• group benefits associate
• marketing
• health benefits broker
• Health insurance adjuster