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Online Resumes with "Claim "
Registered Nurse - 7 Years of Experience - Near 34105
Certification Licensure and Accreditation through AHCA (the Agency for Health Care Administration) and JC (Joint Commission). Formerly at Avow Hospice, as Manager of Admissions and External Affairs. Implemented Nursing Policies and Procedures to Improve Patient Care and Staff Efficiency coordinated with Compliance and Quality Improvement. Implemented Bedside Electronic PI (Patient Information) System and Compliance for Medi...
Tags for this Online Resume: Nursing, Health Care Industry, Medicare, Patient Care, Planning, Policies and Procedures, Services, Strategic Planning, Regulation Review, Compliance, SouthEast, Florida
Claims Investigator - 20 Years of Experience - Near 11554
I am a well educated professional who has extensive knowledge of life, medical, dental, pharmaceutical, and disability claims. My prowess has allowed me to be successful in retrieving funds from fraudulent claims according to compliance guidelines. I look forward to contributing my skilled attributes to your organization
Tags for this Online Resume: New York, FLMI, CLCU, LOMA, NHCAA, Compliance, Fraud
Case Manager - 2 Years of Experience - Near 60630
Tags for this Online Resume: Claims Adjuster, Fraud, Medical, Referrals, Transportation, Therapy, Management, Billing, Accounting, Assessments
Billing/Coding Specialist - 15 Years of Experience - Near 11201
ACCOMPLISHMENTS Managed communications planning for medical providers at EmblemHealth, Inc. Collaborated with every level of the enterprise. Projects included multiple New York State - mandated incentive payment plans, new healthcare initiatives such as one of the country's first patient-centered care models, creating promotional and training materials for several disease care and wellness programs. Worked with the Product ...
Tags for this Online Resume: Evaluate, Health Care Industry, HIV, Information Technology, Insurance, Management, Medical, Microsoft
Claims Adjuster - 18 Years of Experience - Near 75243
Experienced with Value Stream and Process Mapping. Implemented and managed the revised total loss program, in the Irving and Denver Liberty offices. Achieved significant improvements on rental, storage and salvage processing times. Experience handling Third Party Liability losses for both Operations and Completed operations for Construction, Manufacturing, and Auto Repair facilities as well as other accounts. Managed claims...
Tags for this Online Resume: Management, Property Management, Risk Management, Construction, Customer Service, Manufacturing, Quality, Quality Assurance, Reviews, Training
Contract Administrator - 10 Years of Experience - Near 85395
Areas of Expertise: * Contract Negotiation/Management * Risk Analysis/Management * Team Leadership & Motivation * Project Management Certification * Organizational Leadership * Global Trade Compliance * Employee Training & Development * Budget Management * Sourcing Strategy Development * Claims Defense/Resolution * Legal Management * Vendor/Supplier Management * EAR, ITAR, NRC, & DOE Regulations * Process Reengineering * Ch...
Tags for this Online Resume: Compliance, Legal, Management, Procurement, Project Management, Risk Management, Training, Bankruptcy, Trade Compliance, Litigation, Negotiation
Loan Counselor - 14 Years of Experience - Near 76060
Experienced professional with supervisory experience, a diverse mortgage background in areas of Collections, Bankruptcy, Foreclosure, QA monitoring, Loss Mitigation, VA Claims, Escrow- Flood, Taxes, and MPI insurance experience and mortgage file review. Strong analytical and planning skills combine with ability to coordinate the efforts of many to meet organizational goals. Key strengths include excellent organizational ski...
Tags for this Online Resume: ACD, Automatic Call Distribution, bankruptcy, Call Center, Cms, Management, Audit, Forecast, Load Balancing, Scheduling
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
Lawyer - 14 Years of Experience - Near 02139
PROFILE Experienced trial attorney focused on outstanding results through targeted discovery and excellent oral and written advocacy. * Tried to verdict more than 30 civil cases in Superior and District Courts * Twenty years of experience investigating, trying, and resolving personal injury and property damage claims * Conducted trainings and workshops for insurance company management, claims adjusters and other stakeholder...
Tags for this Online Resume: Fraud, Management, Civil Litigation, Drafting, Estate planning, Litigation, Planning, Probate, Wills, Benefits
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
Family or General Practitioner - 1 Years of Experience - Near 60466
Tags for this Online Resume: ACLS, Acute Care, Automobile Claim Law Specialist, Cardiopulmonary resuscitation (CPR), Health Care Industry, Inventory, Medic, Medical, Neurological, Nursing
Data Mining Specialist
SUMMARY OF QUALIFICATIONS * Data Extraction and manipulation of complex data sets using SQL and SAS * Perform statistical analysis using R and Excel Data visualization using Tableau * Experience of using EHR & claims data of OPTUM, TRUVEN and CMS Medicare for a wide variety of projects Understanding of Insurance billing & coding CMS payment models
Tags for this Online Resume: CT, Research, Spring, Billing, Cardiology, Clinical Research, Cms, Coding, Data Dictionary, Data Extraction
