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Online Resumes with "Claims Adjudication"



Admissions Director

Summary of Qualifications * Possess expertise in managing daily operations of Hospital Admissions and Information departments, Emergency Room Registration, medical office records and operating expenses. * Experienced in performing annual performance evaluations for department personnel and supervisory staff. * Successfully prepared hospital departments for audits and reviews, which resulted in 100% passing rates. * In depth...

Tags for this Online Resume: College Educator: Bio Sci, Medical record documentation, Analytical, Practitioner/Practice management, Emergency Room Regristration, Medical Claims Adjudication, Director of Admissions, Diagnostic & Treatment Coding, Washington DC - Metro area, Managed Care

Business Analyst - 6 Years of Experience

Experience Summary * 7.9 years of experience in IT industry and immense knowledge about US healthcare domain and 5 years of experience in closely working with Business by Managing Various Client Projects. * 10 months of experience in the USA, California in CRM leads management using Salesforce. * Project Manager Expertise includes Planning and Defining Scope in Documentation of client requirements and translates them into d...

Tags for this Online Resume: Management, System design, Test, Test Plan, Coding, Monitoring, Project Management, Scheduler, Stored Procedures, Structured Query Language

Business Analyst - 7 Years of Experience - Near 37209

Professional Summary * Over 8+ years of diverse experience as a Business System Analyst in developing and implementing innovative business processes. * In-depth knowledge and experience in full SDLC with RUP, agile and waterfall methodologies. * Functional experience in health Care Industry with vast knowledge on Medicare and Medicaid. * Expertise in creating the companion guides on various EDI transactions. * Specialize in...

Tags for this Online Resume: Management, Structured Query Language, Business Requirements, Microsoft Visio, Oracle, Use Cases, VISIO, Business Analysis, Business Analyst, Health Insurance Portability And Accountability Act, agile, software, html, c++, sql, medicaid, CMS, HIPPA, Testing

Regional Sales Manager

High energy, driven sales professional, exceptional teaching and communication skills.

Ideal Companies: Aetna, Cigna, Delotte, Ernst& Young, WellPoint, MetLife

Tags for this Online Resume: marketing, business development, account management, pricing

Manager - 20 Years of Experience - Near 11743

Areas of Expertise * Lean Six Sigma BPM business analysis for technical and business solutions evaluate/implement business process through Six Sigma methodology by identifying and mapping technology with business needs. * My corporate Vision includes driving efficiency of operations, increasing quality of service by partnering with business units and achieve strong bottom-line performance applying Lean Six Sigma methodology...

Tags for this Online Resume: Support, Technical Support, Customer Relationship Management, Disaster Recovery, Fixed Assets, Inventory, Network Support, network, vm, azure, was, client services, vendor management, data center

Quality Assurance Specialist - 7 Years of Experience - Near 43230

career as Associate Trainee in Cognizant technology Solutions. * Developed Keyword driven framework for mainframes in a team of 2. * Have worked on various frameworks like DataDriven Modular and Hybrid Driven frameworks. Experience in Test Requirements gathering requirements analysis and test strategy/plan preparation. Developed numerous tools with Excel macro to interact with QC/ALM. * A self-motivated person with strong c...

Tags for this Online Resume: Automation, Test, Test Cases, Regression Testing, Functional Testing, HP QuickTest Professional, sql, agile, selenium webdriver, TESTNG, UFT, framework

Quality Assurance Specialist - 5 Years of Experience - Near 80126

PROFESSIONAL SUMMARY I have 12+ years of experience in Quality Assurance, Systems Integration, Lab Design and Operation, Java Application Development, Distributed Application Development, Object Oriented Programming, Internet/Intranet-based database applications development, testing and implementation using Java/J2EE (Servlets, JSP, EJB). My roles have included all phases of the software development life cycle (SDLC), but e...

Tags for this Online Resume: Test, Management, Applications, Services, Billing, Linux, Agile, Automation, Call Center, Configure

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

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

Human Resource Labor Relationship Specialist - 20 Years of Experience - Near 08054

Qualifications for Employee Relations/EEO Officer Investigated discrimination claims and directed remedial action for 16 years in preparation for trial. Lead the settlement of disputed claims of discrimination for less than 50% of their initial assessed risk value. While representing management and employees in employment law case in litigation achieved a 93% success rate. I am looking for a non-litigation position where I ...

Tags for this Online Resume: ADA, Ada Programming Language, Benefits, Complaints, Computer Aided Software Engineering, Employee Relations, LESS, Litigation, Management, employee relations, human resources, recruiter

Business Analyst - 7 Years of Experience - Near 60661

Summary: * Qualified professional with more than 7 years of experience as a IT Business Analyst in Healthcare and Banking Industry. * Highly motivated team player with excellent communication, presentation and interpersonal skills, always willing to work in challenging and cross-platform environment. * Demonstrated ability to work actively in different phases of Software Development Life Cycle (SDLC) using Waterfall, RUP an...

Tags for this Online Resume: Business Analysis, Business Requirements, Insurance, Microsoft Visio, Structured Query Language, Unified Modelling Language, Use Cases, agile, Risk analysis, Impact analysis, Change management, EDI Claims