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Online Resumes with "Claim Process"
Assistant Director - 20 Years of Experience - Near 70058
Professional with over 15 years of experience in administration and benefits administration, accounting and business finance, business development and management, education, employee relations, and social services. Experience in compensation, medical pension benefits, claims processing and disability law. Over 10 years’ experience in Accounting, bookkeeping, marketing and sales.
Tags for this Online Resume: Management, Critical Thinker, Report Writing, Writer, Accounting, Presentation, Organization
Claims Examiner - 20 Years of Experience - Near 19506
A highly successful, proven property and casualty claims leader skilled claims process improvement, outstanding customer experience and highly effective claims outcomes. Constantly strives to create a culture of engagement on all levels to find opportunities to improve profitability, effectiveness, claim processing. Experienced in developing and using metrics and analytics to effectively achieve key corporate objectives r...
Tags for this Online Resume: Specialty, Leadership, Complex, Management, Philadelphia, Pennslyvania, New Jersey, Litigation, Call Center, CFO, Compensation, Financials, Outsourcing, Risk Analysis
Speciaty Pharmacy Technician - 9 Years of Experience - Near 60624
Obtain
Tags for this Online Resume: benefits investigation, prior authorizatis, claims Processing, copay assistance
Claims Examiner - 20 Years of Experience - Near 24014
I have been in the Health Insurance business for 31+years. During this time I have been from data entry, customer service, executive inquiry, underwriting, provider contracting,Quality Analyst, Internal Provider Relations Representative, Provider Date Analyst (loading provider and fee schedules), outside Provider Relations Consultant. I am currently working through a temporary agency with Anthem as a Quality Analuyst.
Ideal Companies: Anthem, United Health, Health Insurance
Tags for this Online Resume: Contracting Analyst, Provider Relation Consult, Quality Analyst, , Provider Contractor, Provider Relations Consultant, Fee schedule loads, analyst, health insurance claims, provider relations
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
Customer Service Representative - 33 Years of Experience - Near 27565
Tasked with effectively delivering high quality service by accurately assessing client needs, researching issues, tracking escalations, coordinating with various internal partners to complete any necessary updates to systems, claims, etc. Possess extensive knowledge of claims processing, all State and Federal Statutes (i.e., HIPAA, ACT). Organized and detail-oriented, dedicated to improving efficiency and productivity. Fo...
Tags for this Online Resume: Creative Problem Solver, Client Relations, Excellent Communication Skills, Dedicated Team Player, Adept Multi-Tasker, Customer Focused, Process Improvement Oriented , Benefits, Medical, Medical Records, Account Management, Analytical Thinker, Billing, Claim Processing, Communication Skills
Business Analyst - 20 Years of Experience - Near 46254
As an accomplished professional with extensive experience in providing supportive customer focused service, offering an innate ability to develop sold relationships that enable the gathering of client needs, I am poised to make significant contributions as part of your organization’s team. I bring a strong capacity to assess information and data to identify strategies that address customer objectives. Additionally, I am a...
Tags for this Online Resume: Customer service, problem solving, document analysis, Process improvement, Claims processing, CPT/HCPCS, Medical terminology, Business analysis
Chief Information Officer - 25 Years of Experience - Governance, BI, Consulting Principal, BI, Healthcare, Engagement Manager, Project and Program Management
Desire for a position in a fast pace company where I can have an impact as an Executive or Delivery Consultant. I wish to leverage my background crosses multiple industries and ranging in size from VC start up to Fortune 10. I love to work with peers, managers and partners to develop solutions, technology, process nd people.
Ideal Companies: Ernst & Young, Dell Enterprise, Deloitte, GE Healthcare, Xerox, Fidelity
Tags for this Online Resume: CIO, RCM, Consulting, BI and Analytics, Application Development, GE Healthcare, Healthcare Technology, Business Intelligence, Practice Management Systems (PMS), EMRs, Enterprise Governance, Data Governance, CMMi, SAS-70, SSAE-19, ASP, Call Center, Accountable Care Organization, Executive Presentations, Software Development, Business Process Outsourcing, ITO, Outsourcing, Strategy, Process Engineering, Technology Management, Project Management, Program Management, Data Quality, Data Security, BI Management, Systems Integration, Healthcare Analytics, Claims Adjudication, Insurance Industry, Property and Casaulty, Life and Health, Healthcare Systems, CTI, Service Management, Engagement Management, Budget > $100M, Technology Standards
Customer Service Representative - 20 Years of Experience - Near 10962
Quality focused problem solver who provides the strategic vision and leadership to optimize productivity. Received numerous accolades for exceeding customer expectations. Worked in target-driven and high-pressure situations; overachieved revenue targets. Skilled implementing quality assurance programs on a matrix basis measured by customer approval and quality. Successful track record handling complicated assignments. V...
Tags for this Online Resume: Customer Service, Work-From-Home, Healthcare, conflict resolution, Call Center Experience, Medical Terminology, type 70 wpm, Problem-solver
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
Test Lead
Summary Currently working as an Associate Manager. My IT experience is ranging all phases of SDLC and across various domains. At high level it can be summarized in Requirement Analysis, Testing and Test Management. At detail level it can be described as Identifying and documenting requirements, Requirement Analysis, Test Approach, Test Estimation, Planning, Test Scenarios and Test Case preparation, Test Data Planning and Pr...
Tags for this Online Resume: Test, Insurance, Capital Market, Tapestry, Claims, Healthcare, Automation, Business Analysis, Test, Services, Accenture FOUNDATION, Accounting, Architect, Automation, Claim Processing, Computer Aided Software Engineering
Sr Claims Adjuster - 13 years Experience - New Orleans
Career objective includes promptly assisting the claimant/policy holder by working in a manner that strengthens the relationship between insured and insurer, by providing clear and accurate information regarding the claim and the claims process to all parties involved, while meeting and exceeding the objectives set by the carrier and simultaneously meeting the needs of my family.
Tags for this Online Resume: New Orleans, Adjuster, Investigator, Claim
