SUMMARY OF QUALIFICATIONS * Detail-oriented with strong analytical, organizational, and problem solving skills. * Excellent written, interpersonal and communication skills, self motivated. * Advanced PC software skills including Microsoft Word, Excel, PowerPoint, Outlook, Rumba, and Custom View & Legacy. * HCPC, ICD-9, CPT & Hospital Revenue Coding * Claims Inquiries & Processing * Knowledge in the IFP/HMO/PPO, DOI, & POS (Point of Service) Benefits & Claims * Knowledge of Adobe Acrobat, Microsoft Word, Excel, Outlook * Outpatient Hospital Adjustments * Direct Contracting * Medical Manager, Fund Pool, Fee for Service * Sun, EPIC, EEP, PIPS, Brain programs * Successful at establishing procedures & coordinating efforts for more productive work flow. * Call Center Customer Service Environment * Ability to work well in Team Environment, focused under pressure * Knowledge of RFP, negotiations Ameribergen

Highlights:

• Benefits
• Medicare
• Policies and Procedures
• POS
• Quality Assurance
• Rumba
• Test
• View (Db W/Vsam Ims Db2)