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Online Resumes with "Adjudications"



Experienced Employment and Human Resources Professional

To use my legal and professional experience to help lead the team of a successful organization, increasing productivity and minimizing conflicts among the workforce.

Business Affairs and Legal Affairs Attorney, Production Attorney

Vice President of Business Affairs at a studio or network

Tags for this Online Resume: Director of Legal Affairs, VP of Business Affairs, Legal Counsel, Production Counsel

General

Tags for this Online Resume: Audit, Management, Procurement, Prime, Pricing, Project Management, Rehabilitation, Acquisitions, Administrative Assistant, Adobe, Contract Management, Subcontract Administration, Dispute Resolution, War Zone Experience, Claims Adjudication, Iraq Oil Field Experience

Claims Examiner - 20 Years of Experience - Near 78660

KEY QUALIFICATIONS * Highly-skilled claims manager strong oral and written communication skills * Proven track record of integrating process improvements to increase business profitability * Extensive understanding of Oklahoma/Texas WC statutes, case laws and claims adjudication * Excels in leadership, training and mentoring

Tags for this Online Resume: Compensation, Automation, Claim Processing, Litigation, Management, Recruiting, Training, Medicare, Communication Skills, Computer Aided Software Engineering

Claims Investigator - 18 Years of Experience - Near 33604

Summary Claims Investigator with over 12 years of experience in investigating and managing various disability claims (Workers Compensation and LTD) which was reinforced by SIU fraud field experience meeting claimants, employers, and physicians in person and obtaining recorded and written statements, as well as arranging/reviewing surveillances and state fraud reporting. Recent employment as a desktop investigator for a Comp...

Tags for this Online Resume: contract interpretation, Management, File Documentation, Worker's Compensation, Database, Research, Field Investigations, Claims, Fraud Investigator, Desktop Investigator, LTD Disability, Interviews statements, Accurint Lexis Nexus, Word Excel powerpoint, Excellent written and oral communication

State Government - 15 Years of Experience - Near 85213

KEY QUALIFICATIONS - Bilingual Spanish/English -Operate all Office Equipment -Microsoft Office Applications - Data Entry Skills -Communication Skills -Interpretation of Laws & Rules - Electronic Cash Register - Customer Service Skills -Bookkeeping Skills STATE OF ARIZONA, DEPARTMENT OF ECONOMIC SECURITY-UNEMPLOYMENT INSURANCE QUALITY CONTROL / BENEFIT ACCURACY MEASUREMENT 02/01/15 TO 7/14/2016 Benefit Accuracy Measurement (...

Tags for this Online Resume: Accounting, Applications, Audit, Audit Compliance, Benefits, Bili0ngual, C# Programming Language, Coding, Communication Skills, Compliance, leasing consulting

Business Analyst

Summary * 7+ years of experience as Business Analyst in the Healthcare Industry with expertise in Affordable Care Act (ACA), HL-7, EDI Transactions (834, 835, 837), HIPAA, MMIS, Medicare and Medicaid. * Adequate knowledge in Health Administration - Claims processing (auto adjudication), COB, EOB/Drafts, Claims pricing and testing, HIPAA, enrolment, EDI, HIX, HMO, PPO, POS, Medicare, Medicaid, CDHP, MMIS system implementatio...

Tags for this Online Resume: Quality, Structured Query Language, Test, VISIO, Jad, Microsoft Office, Microsoft Visio, Rational, Rational Rose, Requisite Pro

Law Enforcement - 5 Years of Experience - Near 20720

SUMMARY Paralegal Intellectual Property Law General Law Adjudicated for TS/SCI Performance driven paralegal with over 22 years of experience in the legal field having more than 20 years focused on Intellectual Property (IP) law. Performs various complex administrative functions related to policies and procedures, coordinate, recommend, direct and evaluate in a support service function. Inactive Clearance with polygraph and ...

Tags for this Online Resume: Filing, Policies and Procedures, Legal, Applications, Documentation, Procurement, Evaluate, Financial Industry, Intellectual Property Law, Management, Reseacher, Detail Oriented

Materials Manager

SUMMARY Healthcare professional with extensive experience in training, management, reconciliation, audit, Medicaid and Medicare regulations. Experienced with federal regulations and compliance. Experienced with analysis and preparing reports for management. Medical claims Adjudication and Network Management.

Tags for this Online Resume: Management, Policies and Procedures, Audit, Business Analysis, Compliance, Medicare, Cms, Complaints, Business Analyst, Integrate

Business Analyst - 7 Years of Experience - Near 08817

Professional Summary: * 10+ years of overall IT experience with 6+ years of Business Analyst / Project Coordination and management expertise in Healthcare and Pharmaceutical Industry. * Lead JAD sessions to aid in requirement gathering, prototyping and documentation of business and system needs via BRDs, FRDs User Stories, Use Cases, Workflows, Wireframes and Software Requirement Specifications. * Expertise in implementing ...

Tags for this Online Resume: Business Analysis, Business Analyst, Information Technology, Acceptance Testing, Active Server Pages, Adobe, Adobe Acrobat, Agile, ANSI, Ansi (Am Natl Stds Inst), PMP certified, VISIO,MS Project

Adjudicator

Tags for this Online Resume: administrative, security clearance, paralegal, analyst, legal assistant, team lead

Legal Counsel, Attorney, Lawyer, Associate Counsel, General Counsel