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Online Resumes with "Claims Adjudication"
Insurance Sales Representative - 20 Years of Experience - Near 30228
SUMMARY OF EXPERIENCE * Licenses: Life, Fixed Annuities, Property & Casualty, Health and Accident * Sales Producer, Inside Sales Agent * Skilled with difficult people * Call Center Proficient, Claims Adjudication * Supervised, Managed
Tags for this Online Resume: Facilitator, Medicare, AIS, Associate in Insurance Services, Benefits, Compensation, Litigation, Workers Compensation, Sales, Medical, insurance, sales
Claims Adjuster - 20 Years of Experience - Near 94545
COVER LETTER: Dear Potential Employer, I'm writing to express my interest in becoming gainfully employed with your company. With a diverse background and over forty (40) of years of overall experience, I bring many tools and skills to the table. I am seeking the right the right opportunity to share my talents with the employer who can best utilize my skill sets. I believe my experience working in a variety of different posi...
Tags for this Online Resume: Budgeting, Compensation, Management, Retail, Workers Compensation, insurance, employee benefits, group benefits associate, benefits consultant, group health benefits, health benefits broker
Customer Service Manager
SUMMARY * Experienced IT Project/Program Manager, Scrum Agile Manager, PMP with several years of diverse experience working for major Financial and Medical Corporations. Over 20 plus years in technology in the financial services industry with broad experience in Wealth Management and investment banking, as well as Major Medical and Pharmaceutical Companies. * Completed successful implementation projects with IBM, Quest-Diag...
Tags for this Online Resume: Management, Quality, Quality Assurance, Quality Management, Financial, Financial Services, Services, Mergers, Program Manager, Agile
Billing/Coding Specialist - 20 Years of Experience - Near 21207
To obtain a rewarding career within the Health Care Industry, and serve the millions of people who rely on obtaining quality and comprehensive medical care, and coverage. Over 25years in the Health Care Profession. I have acquired extensive knowledge in handling business accounts, collection on credit balances, insurance verification and claims adjudication. I have acquired specific training on collecting pertinent data in...
Tags for this Online Resume: Medical, Financial, Insurance, Audit, PART-TIME, BALTIMORE, Management, Billing, Collection, Banking Industry, physical therapist, outpatient physical therapy, healthcare, Financial, insurance, billing, collection, Baltimore
System Engineer
Experienced with AWS Management Console and Amazon IAM implemented in an AD environment. Experienced with AWS security rules to limit communications on a port range basis outside of predefined networking areas. * Performed schema migrations of hospital patient data from Greenway/Progress and Cerner/Oracle databases to SQL Server databases to allow ETL to a centralized cloud based data repository. Created Sybase and Cache OD...
Tags for this Online Resume: Acceptance Testing, Oltp (Online Transaction), Test, Application Installation, Benefits, Benefits Application, Drug Information, Install, Operating Systems, Sun Solaris Operating System
Project Manager
PROFESSIONAL SUMMARY * Sr. Program / Project Manager with over fifteen (15) years of experience with core competencies include Project Management, Change and Risk Management, Client Relationship Management, Resource Management and implementation Management * Managed large programs in PMO's in excess of 9 Million for CVS Health * Assisted in initiating an Agile SCRUM approach in project management * Worked with EPMO directly...
Ideal Companies: Data Wrehousing, Big Data, Project Management
Tags for this Online Resume: Oracle, Oracle Warehouse Builder, Architectural, CIO, Data Warehouse, Design Documents, Documentation, Hyperion, OBIEE, Software
Health Administration/Billing/Coding
Highly motivated and efficient individual with a strong background in insurance, benefits administration, claims adjudication, healthcare information management and medical coding. Demonstrated analytical skills and attention to detail, flexible in performance of job duties and an effective team player.
Claims Adjuster - 19 Years of Experience - Near 12205
Ideal Companies: Health Insmphurance Carrier, Insurance - Self Pay
Tags for this Online Resume: Management, Communications, Complaints, Policies and Procedures, Risk Assessment, Settlements, Strong Work Ethic, Customer Service, FACETS, Lotus
Claims Adjuster
Tags for this Online Resume: Management, Communications, Complaints, Policies and Procedures, Risk Assessment, Settlements, Strong Work Ethic, Customer Service, FACETS, Lotus
Postal Service Mail Processor - 5 Years of Experience - Near 48203
To meet the needs of the Administration industry and related work as required for the company.
Tags for this Online Resume: Switchboard, Word Processing, Microsoft Word, Security, Web-based Proxy Manager, Data Entry, Filing, Medicare, Microsoft, Microsoft Excel
Administrative Assistant - 12 Years of Experience - Near 93536
Ideal Companies: Law Office, Medical Billing, Medical Group
Tags for this Online Resume: Billing, Insurance, Managed Care, Medicare, Quality, Quality Assurance, Quality Control, Bankruptcy, Receivables, Training
Health Technologist - 18 Years of Experience - Near 07079
Experienced results-driven professional with strong leadership and relationship-building skills. Accomplished program manager and application architect with extensive experience in front office and back office operations due to extended exposure to SDLC program delivery in the Fortune 100 business sector.
Ideal Companies: CVS Caremark, Aetna, OptumRx, United Health Group, Humana Pharmacy Solutions, Envolve, Centene, Envision Rx, Anthem, Ingenio, WellCare, Tufts Health Plan, Harvard Pilgrim Healthcare, Healthfirst, McKesson, Amerisource Bergen
Tags for this Online Resume: Acquisitions, Annuity, Architect, Back Office, Compaq, Data Conversion, Data Warehouse, e-Commerce, Financial, Financial Services, PBM, Government Programs, HIPPA Compliant, Operations, Business Process Management, Business Systems Analysis, Shared Services, Lean Six Sigma, Scrum Master, MS Project, MS SharePoint, MS PowerPoint, MS Excel, MS Visio, Relational Database Management, Business Process Modeling Notation, MEGA, Agile Project Management, Waterfall Project Management, Medicare, Health Care Reform, Process Improvement, Formulary, Claims Adjudication, Utilization Management, Business Requirements, Strategy, Salesforce, CRM, EPMO, CMMI, Veeva, Data Science, Data Lake, Business Cases, Procurement, Oracle, Data Governance, Managed Markets, Supply Chain, ROI, Compliance, Vendor Management, Metrics, Reporting, Dashboarding, SDLC, KPI, COE, Trend Analysis, Executive Reporting, Trainer, Remediation, Business Owner, Consulting Services, Affordable Care Act (ACA), Agile Methodology, Applications Architecture, Applications Delivery, Benefits Strategy, Big Data, Budgeting, Business Process Change Management, Business Process Design, Business Processes Improvements, Business Process Flows, Business Process Management Bpm Software, Business Process Mapping, Business Process Modeling Notation (BPMN), Business Process Strategy, Business Process Transformations, Business Systems Consulting, Business Systems Design, Business Systems Implementation, business use case, Capability and Maturity Integration (CMMI) Requirement Management and Requirement Development Training Certification, Capability Maturity Model Integration (CMMI) Assessments, Center of Excellence, Claims Processing, Client Presentations, Client-Server, Collaborative Innovation, Continuous Process Improvement Initiatives, Cross Trainers, Customer Experiences, Customer Relationship Management (CRM), Data Definition Language (DDL), Data Warehousing Systems, DB2, Drug Information, Drug Utilization Reviews, Enterprise Solutions Architecture, Executive Presentations, Gaps Analysis, Government Affairs, HIPAA Compliance, HIPAA Guidelines, HIPPA Regulations, Information Systems Analysis, Internal Consulting, IT Systems Analysis, Key Performance Indicators (KPIs), Leadership, Leadership Mentoring, Mainframes, Management Consulting, Management Dashboards, Matrix Management, Medicare Claims, Medicare Part D, Medicare Prescription Drug Plans, Medication Therapy Management, Mentoring Programs, Microsoft Access, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft SharePoint, Microsoft SQL Server, Microsoft Visio, Microsoft Word, multi-tiered communication, Needs Assessment, New Product Introduction (NPI), Object-Relational Database, Object-Relational Databases (ORD), People Leadership, Performance Management Reporting, Performance Metrics, Pharmacy Benefits Management (PBM), Pivot Tables, Portfolio Management, Predictive Analytics, Prescriber, Prescription Drugs, Process Improvement Management, Process Reengineering, Procurement Operations, Project Management Life Cycle, Relational Database Management System (RDBMS), Requirements Traceability Matrix (RTM), Return on Investment (ROI), Scrum Methodology, Solution Architecture, SQL Relational Databases, Strategy Creation, Structured Query Language (SQL), Sybase, Systems Development Life Cycle (SDLC), Technical Project Management, Therapeutics Committee, Training the Trainer, Unified Modeling Language (UML), Use Cases, Waterfall Model, Web Based Services, Writing User Stories
