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Online Resumes with "Appeals Process"
Healthcare Risk Management/Performance Improvement/Patient Safety Leader
Leadership position in Patient Safety/Risk Management/ Performance Improvement
Ideal Companies: Health Systems, Pharmaceutical Companies, Medical Device Companies, Healthcare Software Companies, Healthcare Consulting Firms
Tags for this Online Resume: Patient Safety, Risk Management, Performance Improvement
Education Administrator - Leader - Relationship Builder
As a relationship builder, I value the person-centered approach to working with both internal and external clients in any organization. To meet the needs of these individuals strengthens the creativity and production of those being served and those serving them. This kind of attention to the entire organization will support a win-win outcomes for all of the stakeholders. I adhere to three concepts, Integrity, Innovatio...
Ideal Companies: Colleges, Corporations
Tags for this Online Resume: Relationship Builder, Education Administrator, Art/design Educator, Marketing and Sales, Account Manager, Visionary, Counseling Backgound, Trainer, Workshop/Seminar Facilitator, International Experience
Featured Profile
Featured Profile
Healthcare Executive Profile
My career objective is to attain a Healthcare Executive position within a progressive company. With my current studies in the Ph.D. Health Services with a concentration in Health Administration; various nursing capacities and vast Managed Care leadership;I will be an asset to the organization. In addition, I have extensive experience in presentations, networking, staff development,strategic planning, class training and faci...
Ideal Companies: McKesson, NEA-Baptist, , Amgen, Bayer Pharmaceuticals, Roche Pharmaceuticals, Bristol-Myers Pharmaceuticals, BlueCross BlueShield, St. Vincent Hospital, Celgene, Veterans Administration, UAMS-Little Rock
Tags for this Online Resume:
Milliman, Microsoft Word
Featured Profile
Sr. Medical Billing Representative
Highly Skilled Accounts Receivable Representative with over 15 years’ of medical and business billing experience. Proven expertise working with patients to resolve Medicare / Medicaid denials and submit appeals. Skilled at medical coding, medical billing, processing medical claims, and performing insurance research.
Ideal Companies: Hospital
Tags for this Online Resume:
Billing Coding, Medical Terminology, Collections, Office Administration, Data Entry, Medical Coding, HIPPA Standards
Featured Profile
Operational Risk Manager, Operations Manager, Jacksonville FL 24 Years experience
To continue career in Mortgage Operations/Risk Management with a fast paced organization; with opportunity to add value while experiencing continued growth and learning through increased levels of responsibility.
Ideal Companies: Larger, established organizations in the mortgage banking arena
Tags for this Online Resume:
Risk Management, Mortgage Underwriting, Mortgage Processing, Mortgage Credit Review, Mortgage Operations Management, Process Development/Implementation, Team Building/Mentoring/Performance Management
Billing/Coding Specialist - 15 Years of Experience - Near 46755
Experienced and Certified Hospital/Inpatient/Outpatient Medical Biller. Excelled in reducing patient accounts receivable balances. Succeeded in high client revenue by using Complete Revenue Solutions-Action Plans, Goals, and Timelines. Executing improvement in production- increased Revenue, HIPPA billing compliance -registration issues, improving current claims process, refine remittance advices, cleaner claims, appeals pro...
Registered Nurse - 20 Years of Experience - Near 15005
Looking for telecommuting UM services. I am the nurse for a position of this type. I am experienced in front line nursing as well as UM/CM/appeals processes. Resume with clinical experience enclosed. Applying for evening UM review RN (Remote) I have been an RN for 30+ years. I am experienced in front line nursing as well as UM/CM/appeals processes. Resume with clinical experience enclosed. I am focused, dedicated, dis...
Claims Investigator - 10 Years of Experience - Near 07823
PROFESSIONAL SUMMARY: Core Qualifications: * Proficient in data management, web applications, Microsoft Office suite including Excel, Power Point, Publisher, Adobe Suite and other specialty specific software applications * Accomplished in medical claim verification of coverage, denial and appeal processes * Facile in coordination of post-acute care patient needs * Skilled in all aspects office management, including scheduli...
Tags for this Online Resume:
Denials, Billing, Claims, Financial Services, Compliance, Managed Care, Recoupment, Investigation, Insurance, Appeals, Regulations, Hackettstown, NJ
Manager
Experienced with Health Maintenance Organization complaint, grievance and appeal processes. Implemented Workforce management technology for call center staffing. Developed and designed monthly reports that depicted key Customer Service and Mail Center Indicators for Senior Management and the Board of Directors at MDNY Healthcare. Worked with the IT department to design and develop an in-house system to track customer calls ...
Tags for this Online Resume:
Purchasing, Quality, Quality Assurance, Staffing, Staffing & Recruitment, Strategic Planning, Test, TQM (Total Quality Management), Workforce Management, Written Communication Skills
Case Manager - 6 Years of Experience - Near 01033
To obtain a position that will showcase my skills and diverse background in the healthcare industry while allowing my continued professional growth and goal attainment within the company's vision. Background Qualifications: -Detailed oriented, with extensive experience in case management at the Ltach and SNF levels of care -Ability to work in high stress positions dealing with peers, patients, families, medical staff, and p...
Tags for this Online Resume:
Dialysis, Management, Pulmonary, Utilization Management, Insurance, Medicare, Assessments, Documentation, Marketing Management, Referrals
Featured Profile
Healthcare Executive Profile
My career objective is to attain a Healthcare Executive position within a progressive company. With my current studies in the Ph.D. Health Services with a concentration in Health Administration; various nursing capacities and vast Managed Care leadership;I will be an asset to the organization. In addition, I have extensive experience in presentations, networking, staff development,strategic planning, class training and faci...
Ideal Companies: McKesson, NEA-Baptist, , Amgen, Bayer Pharmaceuticals, Roche Pharmaceuticals, Bristol-Myers Pharmaceuticals, BlueCross BlueShield, St. Vincent Hospital, Celgene, Veterans Administration, UAMS-Little Rock
Tags for this Online Resume:
Milliman, Microsoft Word
Featured Profile
Sr. Medical Billing Representative
Highly Skilled Accounts Receivable Representative with over 15 years’ of medical and business billing experience. Proven expertise working with patients to resolve Medicare / Medicaid denials and submit appeals. Skilled at medical coding, medical billing, processing medical claims, and performing insurance research.
Ideal Companies: Hospital
Tags for this Online Resume:
Billing Coding, Medical Terminology, Collections, Office Administration, Data Entry, Medical Coding, HIPPA Standards
Featured Profile
Operational Risk Manager, Operations Manager, Jacksonville FL 24 Years experience
To continue career in Mortgage Operations/Risk Management with a fast paced organization; with opportunity to add value while experiencing continued growth and learning through increased levels of responsibility.
Ideal Companies: Larger, established organizations in the mortgage banking arena
Tags for this Online Resume:
Risk Management, Mortgage Underwriting, Mortgage Processing, Mortgage Credit Review, Mortgage Operations Management, Process Development/Implementation, Team Building/Mentoring/Performance Management
Billing/Coding Specialist - 15 Years of Experience - Near 46755
Experienced and Certified Hospital/Inpatient/Outpatient Medical Biller. Excelled in reducing patient accounts receivable balances. Succeeded in high client revenue by using Complete Revenue Solutions-Action Plans, Goals, and Timelines. Executing improvement in production- increased Revenue, HIPPA billing compliance -registration issues, improving current claims process, refine remittance advices, cleaner claims, appeals pro...
Registered Nurse - 20 Years of Experience - Near 15005
Looking for telecommuting UM services. I am the nurse for a position of this type. I am experienced in front line nursing as well as UM/CM/appeals processes. Resume with clinical experience enclosed. Applying for evening UM review RN (Remote) I have been an RN for 30+ years. I am experienced in front line nursing as well as UM/CM/appeals processes. Resume with clinical experience enclosed. I am focused, dedicated, dis...
Claims Investigator - 10 Years of Experience - Near 07823
PROFESSIONAL SUMMARY: Core Qualifications: * Proficient in data management, web applications, Microsoft Office suite including Excel, Power Point, Publisher, Adobe Suite and other specialty specific software applications * Accomplished in medical claim verification of coverage, denial and appeal processes * Facile in coordination of post-acute care patient needs * Skilled in all aspects office management, including scheduli...
Tags for this Online Resume:
Denials, Billing, Claims, Financial Services, Compliance, Managed Care, Recoupment, Investigation, Insurance, Appeals, Regulations, Hackettstown, NJ
Manager
Experienced with Health Maintenance Organization complaint, grievance and appeal processes. Implemented Workforce management technology for call center staffing. Developed and designed monthly reports that depicted key Customer Service and Mail Center Indicators for Senior Management and the Board of Directors at MDNY Healthcare. Worked with the IT department to design and develop an in-house system to track customer calls ...
Tags for this Online Resume:
Purchasing, Quality, Quality Assurance, Staffing, Staffing & Recruitment, Strategic Planning, Test, TQM (Total Quality Management), Workforce Management, Written Communication Skills
Case Manager - 6 Years of Experience - Near 01033
To obtain a position that will showcase my skills and diverse background in the healthcare industry while allowing my continued professional growth and goal attainment within the company's vision. Background Qualifications: -Detailed oriented, with extensive experience in case management at the Ltach and SNF levels of care -Ability to work in high stress positions dealing with peers, patients, families, medical staff, and p...
Tags for this Online Resume:
Dialysis, Management, Pulmonary, Utilization Management, Insurance, Medicare, Assessments, Documentation, Marketing Management, Referrals
Healthcare Executive Profile
My career objective is to attain a Healthcare Executive position within a progressive company. With my current studies in the Ph.D. Health Services with a concentration in Health Administration; various nursing capacities and vast Managed Care leadership;I will be an asset to the organization. In addition, I have extensive experience in presentations, networking, staff development,strategic planning, class training and faci...
Ideal Companies: McKesson, NEA-Baptist, , Amgen, Bayer Pharmaceuticals, Roche Pharmaceuticals, Bristol-Myers Pharmaceuticals, BlueCross BlueShield, St. Vincent Hospital, Celgene, Veterans Administration, UAMS-Little Rock
Tags for this Online Resume: Milliman, Microsoft Word
Sr. Medical Billing Representative
Highly Skilled Accounts Receivable Representative with over 15 years’ of medical and business billing experience. Proven expertise working with patients to resolve Medicare / Medicaid denials and submit appeals. Skilled at medical coding, medical billing, processing medical claims, and performing insurance research.
Ideal Companies: Hospital
Tags for this Online Resume: Billing Coding, Medical Terminology, Collections, Office Administration, Data Entry, Medical Coding, HIPPA Standards
Operational Risk Manager, Operations Manager, Jacksonville FL 24 Years experience
To continue career in Mortgage Operations/Risk Management with a fast paced organization; with opportunity to add value while experiencing continued growth and learning through increased levels of responsibility.
Ideal Companies: Larger, established organizations in the mortgage banking arena
Tags for this Online Resume: Risk Management, Mortgage Underwriting, Mortgage Processing, Mortgage Credit Review, Mortgage Operations Management, Process Development/Implementation, Team Building/Mentoring/Performance Management
