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Online Resumes with "Claim Reviews"



Physician - 20 Years of Experience - Near 85086

Utilize my experience and knowledge of medical practice and insurance industry ( health insurance, managed Medicaid/Medicare, workers compensation, disability). Develop cost containment programs to promote medically efficient health care with quality.

Tags for this Online Resume: medical director, Office only orthopedic practice, alternate payment, Bundled Payment, Risk arrangement contracting, Fraud and Abuse, claims review, Medical Management, Health Insurance, Managed Medicaid and Medicare, Occupational Medicine, Workers compensation, outpatient rehabilitation, disability

Medical Office Manager - 15 Years of Experience - Near 77532

SUMMARY OF QUALIFICATIONS: Ten years of Clinical Management 18+ years of CCMA/Management Managing remote clinical sites Budget and P&L AP/AR, Revenue Cycle Management Experience with Medical Information Management Systems (HIM) Efficiency Management Analytical Thinker (Also think 'outside the box) Strategic Planning Marketing the practice/business Experience with Workers Compensation, Referrals Management, Medicare/Medicaid...

Tags for this Online Resume: Practice Manager, Clinical Management, Management, Referrals, Satellite, Strategic Planning, Surgery, Surgical, healthcare

Registered Nurse - 20 Years of Experience - Near 40515

Summary 10 years experience with a Health Insurance Plan in Utilization Management and current role as Clinical Financial Analyst and Appeals Nurse Specialist for a Medicare Advantage Plan.

Tags for this Online Resume: Managed Care, Cms, Medicare, Patient Care, Reinsurance, Utilization Management, registered nurse, utilization review nurs, Claims Review Nurse

Controller - 20 Years of Experience - Near 19605

SUMMARY Extensive accounting, financial and administrative experience. Excellent interpersonal, managerial, communication and negotiating skills. In-depth knowledge of how to conduct effective foreign business transactions. SELECTED ACCOMPLISHMENTS/EMPLOYMENT EXPERIENCE Fleetwood Fixtures Reading, PA 2003 - present (Store Fixture Manufacturer) Controller/Senior Financial Analyst As Controller, responsible for all accounting...

Tags for this Online Resume: Purchasing, apparel, Budget Preparation, Budgeting, General Ledger, Inventory, Accounts Payable, Financial, Financial Statements, Accounting, accounting, finance, tax, manufacturing, gaap, excel, accountant, controller, audit, Assistant Controller, Financial analyst

Department Manager - 14 Years of Experience - Near 41095

PROFESSIONAL SUMMARY Safety Supervisor with a stellar record of workplace safety improvements and driving regulatory compliance and employees' health and safety across industries - manufacturing and distribution. QUALIFICATION SUMMARY Safety and Risk Management * Proven ability to design, direct and implement effective health & safety program for over 600 employees - designed on-site safety training program- manufacturing a...

Tags for this Online Resume: Compensation, Compliance, Management, Occupational Safety and Health Act, OSHA, Risk Assessment, Training, Workers Compensation, Chemistry, Cardiopulmonary resuscitation (CPR)

Insurance Underwriter

Underwrite profitable commercial business with specific emphasis on risk selection, coverage limits, rate analysis and claims review.

Tags for this Online Resume: Underwriter, Wholesale, Distribution, Real Estate, Underwriting, Retail, insurance, customer service, sales, marketing

Executive Vice President - 17 Years of Experience - Near 90606

Summary of Qualifications: 15 years as Corporate Director/Manager Environmental Health and Safety Providing technical support to includes training, developing, and performing assigned environmental health & safety related compliance programs in Heavy, Medium and light Industrial Manufacturing and production in privet and government( Sergeant Fletcher, BAE, NASA/JPL, EMCOR Government Services), manufacturing( Covalence Plast...

Tags for this Online Resume: Audit, Cardiopulmonary resuscitation (CPR), Compliance, English Language, First Aid, Forklift, Government, Management, Manufacturing, Medical

Business Analyst - 5 Years of Experience - Near 60466

Familiarity with source control concepts (checking in code, branching, checking out) * Experience writing scripts for automation processes. * Experience with mainframe applications * Experience with IBM technology suites * Experience with SQL, JAVA, Phython and C# programming languages. * Successfully implemented and deployed (systems upgrades, code changes, claim adjudication, application changes) releases across all 5 (IL...

Tags for this Online Resume: Management, Support, Quality, Services, Training, Analytical Skills, Customer Service, Research, PeopleSoft, Computer Aided Software Engineering

Safety Engineer - 2 Years of Experience - Near 32822

SUMMARY EDUCATION: 2000-2003 * 2003-2006 * 2004 Middle School High School Professional Academy Of Health Heritage Pine Ridge P.A.H Deltona, FL. Deltona, FL. Orlando, FL. -Outstanding Academic -Congressional Student -Nursing Assistant Diploma& Lic. P: http://www.mastercorpinc.com 484 - 1752 P: Alabama) http://www.beis.com 285 - 1400 977 *Refineries/Chemical Plant (Baton Rouge, Louisiana) P: (281)-807-8200 http://www.brockgro...

Tags for this Online Resume: Financial, AT&T, Benefits, Carpenter, Compensation, Email, Infrastructure, Manufacturing, Read Prints, Services

Executive Assistant

I am a professional assistant with 26 years of administrative experience managing business relations and special projects at a senior management level. I have proven analytic, problem solving and organizational abilities. My skills include mentoring the administrative staff of the division, and other established general administrative requirements of the organization, while maintaining a high level of confidentiality. My go...

Tags for this Online Resume: Administrative Assistant, Benefits, Call Center, Cellular, Copy Machine, Data Entry, Disaster Recovery, Employee Relations, HP, Hub

Insurance Sales Agent - 19 Years of Experience - Near 44110

Profile An innovative, high performance insurance specialist with over 15 successful years of experience combined with exceptional project management, contract administration, and communication skills. Versatile and adept at investigative techniques and program operations. Core competencies include: * Insurance * Leadership/Management * Sales * Medicare * Program Oversight * Medicaid * Marketing * Research & Analysis * Clai...

Tags for this Online Resume: Insurance, Communication Skills, Compliance, Leadership, Management, Marketing Management, Medicare, Project Management, Research, Reviews

Human Resource Consultant

PROFESSIONAL SUMMARY Subject Matter Expert of Human Resources Management Program, Applicant Screening, Pre-Employment Process, New Hire Orientation and On-Boarding Process, Training and Development Programs, Performance Assessment Reviews, Equal Employment Opportunity Compliance (EEOC), Family Medical Leave Act (FMLA), Workers' Compensation Claims Reviews, Occupational Safety Health Administration (OSHA), Labor Relations Tr...

Tags for this Online Resume: Human Resources, Recruiting, Training, Appraisals, Audit, Benefits, Cardiopulmonary resuscitation (CPR), Compensation, Cost Control, First Aid