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Online Resumes with "Audit claims"
Governance / Configuration Designer and Manager
To use my expertise and knowledge providing essential support to my company and clients. Mentorship is very important to me and an excellent process to strengthen an organization from the inside.
Ideal Companies: 3M, Leidos, Virgin, Gartner, Miter, McKinsey & Company, Booze Allen Hamilton, Accenture
Tags for this Online Resume: Project Initiation, Project Schedule, Risk Management, Change Management, Configuration Management, Service Governance
Business Consultant, Benefit/Provider/Claims Configuration, Business Analyst
Twenty plus years in healthcare management and staff support roles in handling medical, claims encounter and dental claims processing, claims auditing, user acceptance testing, EMS billing, AAPC, DRG coding reimbursement, and configuration of various healthcare payers/providers for Medicare, Medicaid, TPA, and Commercial Managed Care products. Strong understanding of healthcare business operations, with a focus on configur...
Tags for this Online Resume: Telecommute, Benefit Configuration, Provider Confguration, SQL queries, User Acceptance Tester, 837p/837I XML/X12, Clearquest
Medical or Health Services Manager - Near 07102
SUMMARY OF CAREER PROFILE I am a highly creative and innovative Healthcare professional with strong Audit, Claims and Benefit Test Analyst background, 25 years experience.
Tags for this Online Resume: Benefits, Audit, Coding, Management, Test, Pricing, Process Improvements, Quality, Quality Assurance, Applications, Time Management, Organizational Skills, Microsoft Office, Attention to Details, Medical Claims Examiner, Enrollment Specialist, Analytical Skills
Operations; Process Improvement; Business Analysis; Quality Assurance; Sarbanes Oxley Compliance; Quality Control
I have a successful track record for process improvement as a result of my extensive background as the National Claims Audit Manager, Claims Manager; Unit Manager; Operations Auditor; Project Coordinator; Litigation Specialist; Claims Training Specialist and Claims Supervisor for Mercury Insurance Group (MIG), in insurance claims management and business operations management. I have been able to restructure existing departm...
Ideal Companies: Walt Disney Companies; South County Outreach; Automobile Club Southern CA;
Tags for this Online Resume: Process Improvement, Business Transformation, Quality Assurance, Sarbanes Oxley Compliance, Cost Control
Claims Adjuster - 5 Years of Experience - Near M6E 2H6
Qualification Summary : B.H.M.S - Bachelors of Homoeopathy In Medicine & Surgery. Has knowledge of Homoeopathy as well as Allopathy medicine with all medical terminology. 3 years and 4 months experience as a claim adjuster in Raksha TPA Pvt. Ltd. i.e. Third party administrator company settling mediclaims (Health insurance claims) on behalf of government insurance companies. 2 years experience as a medical officer in a hospi...
Tags for this Online Resume: Audit, Fraud, Insurance, Management, Medical, Vitals, Communication Skills, Government, Health Insurance, Insurance Claims
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
Director of Supply Chain - 20 Years of Experience - Near 33511
QUALIFICATIONS: 1977 - 2013 Verizon Communications Accomplished with a dynamic 36-year history of leadership in multiple operations including 13 years of executive level management within Verizon Communications. Defined as a results focused executive with key roles/responsibilities dedicated to improving shareholder value and company growth. Director Supply Chain Management - Logistics Services Director Supply Chain Managem...
Tags for this Online Resume: 3PL, Account Management, Audit, Business Requirements, Capital Expenditures, Customer Relationship Management, Data Analysis, English Language, Financial, Forecasting
Billing/Coding Specialist - 4 Years of Experience - Near 78242
at Position Description: Reviewing claims working off project list or work queue. Responsible for providing expertise or general support in reviewing, researching. Experience in a production based environment with an emphasis on quality outcomes. Primary Resposabilities: * Reviewing and adjudicating medical claims in accordance with CMS claim processing guidelines. * Processing claims Up to 50K * Provide expertise claims su...
Tags for this Online Resume: Microsoft, Microsoft Outlook, Services, Adobe, Audit, Banking Industry, Benefits, Billing, Call Center, Cardiopulmonary resuscitation (CPR)
Quality Coordinator - 19 Years of Experience - Near 60077
SUMMARY * Over 18 years experience in a healthcare environment, with skills ranging from claims adjudicating, workers's compensation. * Extensive experience auditing claims and contracts.
Ideal Companies: VA, Blue cross blue shield, AON
Tags for this Online Resume: Audit, Pricing, Quality Assurance, sheets, Surgery, Test, Billing, Compensation, Complaints, Workers Compensation
Billing/Coding Specialist - 16 Years of Experience - Near 30252
HIGHLIGHTS OF QUALIFICATIONS * Excellent verbal and written communication skills * Strong customer service problem resolution and satisfaction based on customer surveys and feedback * Certified Professional Coder with knowledge of ICD-10, CPT and HCPCS codes * Demonstrated knowledge of Medical Terminology, Anatomy and Physiology * Proficient in billing, coding, policy guidelines, reimbursement and HIPPA guidelines * Excelle...
Tags for this Online Resume: Billing, Business Analysis, Business Analyst, Publications
Claims Examiner - 0 Years of Experience
HAVING 9 years of experience in Insurance Industry actively involved in healthcare insurance and data conversion, development and implementation of supply chain solutions and data analysis with profound experience in automotive and Auto industries. * A highly motivated analyst with vast experience in interpreting, analyzing and reconciliation of data obtained from a variety of sources skills involve development and enhance...
Tags for this Online Resume: Health Insurance, Insurance, Insurance Claims, Data Modeling, Data Queries, Microsoft Excel, Modeling Experience, Quality, Quality Assurance, Customer Service
