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Online Resumes with " Medicare Medicaid"



Case Manager

To utilize my skills as a Mental Health/Substance Abuse Counselor and secure a challenging position which will provide me an opportunity for professional growth. Strong administrative skills in the areas of quality assurance for Medicare and Medicaid funded agencies and private agencies with commercial and private insurance carriers. Strong skills with children, adolescent, young adult and adult treatment services, includin...

Tags for this Online Resume: Assessments, Management, Quality Assurance, Test, Documentation, Facilitator, Nursing, Therapy, Clinical Programs, Social Service

Financial Manager, Branch or Department - 20 Years of Experience - Near 73112

SUMMARY Experienced auditor with diverse background in various governmental audits, manufacturing, and other industries, experienced in financial reporting, complex accounting issues, also experienced in management and development of professional staff. WORKS & PROFESSIONAL EXPERIENCE Sutherland Global Consulting 2401 N.W. 23rd Street, Suite 1A1 Oklahoma City, OK 73107 Cash Manager December 12, 2016 to Present * Oversees th...

Tags for this Online Resume: Internal audit, Audit, Cash Management, Cash Manager, Certified Public Accountant, Consulting, Financial, Financial Reporting, Financial Statement, Insurance, cpa, accounting, gaap, accountant, audit, excel

Medical Office Manager - 20 Years of Experience - Near 75605

SUMMARY OF QUALIFICATIONS * Experienced in Revenue Cycle /PFS, Acute Care Long Term Care SNF and Rehab operations with a diverse healthcare and financial background * Brings over 20 years of healthcare industry skills in finance, business office, billing and collections * Proven and demonstrated leadership skills in Business Office, Medicare/Medicaid, auditing, and project management. * Strong affinity for healthcare, audit...

Tags for this Online Resume: Management, Acute Care, Billing, Policies and Procedures, Project Management, Project Manager, Audit, Budget Control, Budgeting, Cash Management, healthcare, rn, care, pt, outpatient rehabilitation, HEALTHCARE MANAGEMENT CONSULTANT

Medical Office Manager - 13 Years of Experience - Near 70068

SUMMARY OF QUALIFICATIONS * Experienced healthcare professional with in-depth knowledge of Long-Term Care * Skilled with medical terminology, finance, reimbursement regulations, Medicare and Medicaid guidelines * Active participation in State Survey process for both annual and complaint surveys

Tags for this Online Resume: Assessments, Billing, Insurance, Managed Care, Medicare, Financial Industry, Health Care Industry, Medical, Medical Terminology, Surveys

Billing/Coding Specialist - 14 Years of Experience - Near 90620

Summary of Qualifications 21 years in medical field 5 years in leadership role Strong knowledge of anatomy and physiology Strong communication skills Knowledge of computers and electronic health record Basic and advanced life support training Understanding of ICD-9, ICD-10, CPT, HCPCS codes Understanding of billing process HIPAA Knowledge of Medicare and Medicaid Knowledge of HMO, PPO, POS, CDHC 21 years in medical field 5 ...

Tags for this Online Resume: Trauma, Medical, Critical Care - Respiratory, Patient Care, Billing, Coding, Communication Skills, Health Insurance Portability And Accountability Act, ICD 10, ICD-9

Medical or Health Services Manager - 10 Years of Experience - Near 43229

Results-oriented Director of Healthcare Administration with 10 years of proven experience optimizing patient care, operational performance, and financial efficiency. Exceptional communicator well-versed in conducting interviews, staff training, and patient interactions Advanced understanding of Medicare, Medicaid, HMO, PPO, and Managed Care products Proficiency in management information systems, as well as knowledge of ICD....

Tags for this Online Resume: Medicaid, Healthcare , Compliance/Auditing, Strategic Planning, Crendentailing, Budget Management , Process Improvment, Data Management, Billing, Compliance

Medical Secretaries - 13 Years of Experience - Near 87114

PROFESSIONAL SUMMARY * 4+ years of healthcare experience providing helpful patient assistance, administrative support, and managing patient inquiries. * Previously worked for EPOCH Industrial Health Services, ABC Staffing, and Palmilla Assisted Living. * Responded to telephone calls and responded to patient inquiries regarding issues and /or concerns. * Provided options and solutions to inquiries while upholding company uni...

Tags for this Online Resume: Billing, Back Office, Front Office, Medical, Scheduling, Ultrasound, Accounting, Accounts Payable, Inventory, Management

System Engineer

Member of CIO division (Optum technology) Senior Leadership team specialized in implementing Health Care initiatives for Government services handling state programs with budgets of over 15 million USD managed a 100+ team covering Medicare/Medicaid Health Insurance Exchange and Benefit Management handling in-house products like Integrated Eligibility (IE) & Optum Integrated Layer (OIL) and SQA Advisor to the State on impleme...

Tags for this Online Resume: Management, Quality Assurance, Test, Banking Industry, Business Case Development, Compliance, Computer Aided Software Engineering, Consulting, Data General Nova, Program Management

Registered Nurse - 20 Years of Experience - Near 95670

Career Summary: Over 20 years of experience in Acute Care and Health Service programs including Utilization Review, Provider Dispute Resolution, Quality Management, Inpatient and Ambulatory Case Management, and Grievance and Appeals in a managed care environment for both Health Plan and IPA/MSO settings using evidence based nationally recognized criteria such as ACOG, NCCN, MCG, InterQual and Health Plan Medical guidelines ...

Tags for this Online Resume: Compliance, Management, Quality Management, Assessments, Medical, Medicare, registered nurse, healthcare, Managed Care, Utilization Management

Customer Service Supervisor - 8 Years of Experience - Near 94534

Summary Of Qualifications Claims Team Supervisor with strong extensive experience in claims processing. I handled 30-35 examiner in a team. Responsible for Claims Processing, managing Medicare/Medicaid and Commercial insurances, capitation HMO, PPO. Responsible for non-cover claim to support staff for issuance of appropriate denial letters and/or referral to HMO. Responsible for following up on commercial and managed care c...

Tags for this Online Resume: Budgetary, Complaints, Policies and Procedures, ADA, Ada Programming Language, Team Player, Facilitator, HR, Human Resources, Management, call center

Business Analyst - 7 Years of Experience - Near 60661

Summary: * Qualified professional with more than 7 years of experience as a IT Business Analyst in Healthcare and Banking Industry. * Highly motivated team player with excellent communication, presentation and interpersonal skills, always willing to work in challenging and cross-platform environment. * Demonstrated ability to work actively in different phases of Software Development Life Cycle (SDLC) using Waterfall, RUP an...

Tags for this Online Resume: Business Analysis, Business Requirements, Insurance, Microsoft Visio, Structured Query Language, Unified Modelling Language, Use Cases, agile, Risk analysis, Impact analysis, Change management, EDI Claims

Registered Nurse - 15 Years of Experience - Near 07040

Phone: * Prepare program for re-accreditation and ensure that program is in compliance with federal, state and accreditation standards * Manage curriculum design, evaluations and security of curriculum resources * Coordinate instructional technologies, clinical placements and ensure all program operations meet training, certification requirements and regulation standards. * Serve as College Liaison to the New Jersey Board o...

Tags for this Online Resume: Medicare, Public Health, Security, Pharmacology, Quality Assurance, Test, Nursing, Insurance, Leadership, Assessments, Management / Educator