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Online Resumes with "Claims Processing "



Business Analyst - 8 Years of Experience - Near 30281

SUMMARY I have a diverse background from claims processing, provider network management, provider relations, report development and application design. A strong background in data analysis, data mining, as well as test cases extensively in SQL. I am seeking career growth where data analysis, data mining and test casing can be utilized.

Tags for this Online Resume: Audit, Management, Medical, Medical Procedure, Automation, Data Analysis, Data Mapping, Data Mining, Data Quality, Gathering Requirements

Business Analyst - 7 Years of Experience - Near 08817

Professional Summary: * 10+ years of overall IT experience with 6+ years of Business Analyst / Project Coordination and management expertise in Healthcare and Pharmaceutical Industry. * Lead JAD sessions to aid in requirement gathering, prototyping and documentation of business and system needs via BRDs, FRDs User Stories, Use Cases, Workflows, Wireframes and Software Requirement Specifications. * Expertise in implementing ...

Tags for this Online Resume: Business Analysis, Business Analyst, Information Technology, Acceptance Testing, Active Server Pages, Adobe, Adobe Acrobat, Agile, ANSI, Ansi (Am Natl Stds Inst), PMP certified, VISIO,MS Project

Developer - 20 Years of Experience - Near 60194

[03 Months] [06 Months] * Analyzed high-level Software Design Document for Trading Partner Report to divide into number of computer programming tasks and software modules requirements using available database resources. * Designed input and output for required TPR modules and provided capability to extract, update, and modify databases to accomplish migrating newly acquired IBM international transaction processing billing s...

Tags for this Online Resume: Chicago, Information Technology, Mainframe Developer, Cobol, database [DB2, IMS, IDMS], Mainframe Application Developer, COBOL, DB2, IMS, IDMS, CICS, NO Supervision Required, Successfully Implement in Production, Db/Dc, IBM IMS, IMS DB/DC, Support

Business Analyst - 9 Years of Experience - Near 80229

SUMMARY OF QUALIFICATIONS/skills Eighteen years of experience in the IT field of the health care industry with a thorough understating of all major states of Software Development Life Cycle (SDLC). Experienced in all stages of SDLC for various methodologies including Waterfall and Agile Fifteen years of experience in gathering requirements, defining, analyzing, testing, implementing system enhancements, and documentation Te...

Tags for this Online Resume: Benefit Plans, Management, Medical, POS, Software, Test, Unit Testing, EDI, Electronic Data Interchange, Quality Assurance

Programmer Analyst - 15 Years of Experience - Near 27519

Career Summary: * Software professional with 15 years of experience in Information Technology. Specialized in development of applications in IBM Mainframe, COBOL/II/370, CICS, VSAM, JCL, Natural, Adabas, MQ Series, XML, Easytrieve, DB2, IMS DB/DC and IBM utilities. Possesses excellent communication and technical skills and strong sense of personal ownership, accountability and commitment. Highmark - NC Jul '08 - Till date O...

Tags for this Online Resume: VSAM, Xpeditor, Cobol II, Cobol Programming Language, Job Control Language, IBM DB2 Database, TSO/ISPF, CICS, IBM IMS

Insurance Sales Representative - 17 Years of Experience - Near 28086

Profile Sales and Underwriting Skill Highlights Sales Build strong relationships with Customers through individual Home, Auto and Business Insurance Sales. Used Networking to open opportunities inside business to increase individual sales. Active member of 2 Chambers, 2 Women's Networking Groups and 2 Medical Networking Groups. Encourage profitable growth through educating my customers. Met or exceeded sales goals each mont...

Tags for this Online Resume: Customer Service, Underwriter, Sales, Insurance, Life Insurance, Networking, Underwriting, Consultative Sales, Insurance Sales, commercial insurance

Billing/Coding Specialist - 20 Years of Experience - Near 34677

SUMMARY Seeking a position as a Claims Examiner. Skilled in all aspects of evaluating and processing medical, vision, dental, flexible spending accounts and prescription claims with a high degree of accuracy. Possess strong computer skills, especially with Microsoft Word, Excel, and PowerPoint. Strengths are my ability to communicate with various levels of internal and external clients. These abilities are complemented by s...

Tags for this Online Resume: Audit, EDI, Electronic Data Interchange, Medicare, sheets, Claim Processing, Customer Service, Insurance, Nursing, RIMS

Business Analyst - 20 Years of Experience - Near 95833

Summary of Qualifications Provides over twenty (25) years of professional IT HealthCare experience identifying and documenting business and technical requirements, communicating effectively in a multi-disciplinary environment (i.e., business and technical staff, management, clinicians, etc.) and organizational change management experience. My experience includes Twenty (20) years of Medi-Cal (Medicaid) data processing exper...

Tags for this Online Resume: Scheduling, Integrate, SDLC, Test, Test Cases, Business Analysis, Business Analyst, Coding, Health Insurance Portability And Accountability Act, EDI

Featured Profile

Asset Manager - 16 Years of Experience - Near 02762

My years of success have allowed me to gain the experience and traits that can only come to one who has worked in this field as long as I have. I pride myself on the ability to utilize my toolset to locate and capitalize upon areas of improvement involving efficiency, profitability, and cost savings. If any of these traits sound like something your company can benefit from, please feel free to leave me an email and I wil...

Ideal Companies: Open to any companies that offer the opportunity to thrive and advance.

Tags for this Online Resume: Account Management, Asset Management, Automation, Business Development, Forecasting, Information Technology, Inventory, Inventory Control, Asset Management

Supply Chain Manager - 12 Years of Experience - Near 64089

with Responsible for analyzing information to increase profits and efficiencies within the customer base. Managed a full time staff in the areas of freight payment, accounts receivable, overages, shortages, damages and claims processing. * Initiated new processes to increase customer's fiscal year consolidation savings by 7.7%. total NAFTA sales over $1.2 billion and business units in the Crop Protection Garden and Professi...

Tags for this Online Resume: Distribution, Logistics, Management, Purchasing, Accounts Payable, Budgeting, Receivables, Transportation, Transportation Management, Transportation Management Systems

Customer Service Representative - 19 Years of Experience - Near 01824

Summary: Medical Claims Specialist with extensive experience in processing claims, resolving claims issues and providing outstanding customer service Core Strengths: Clerical Complex Problem Solving Customer and Personal Service High Quality Claims Processing Coordination Skills Judgement and Decision Making HIPPA and Fraud Training Medical Skills: Proficient with Medisoft (a medical software application): Medical Terminolo...

Tags for this Online Resume: Quality, Billing, Managed Care, Management, Medical, Medicare, Pricing, Problem Solving, Referrals, Special Procedures

Chief Executive Officer

Profile: * An accomplished and recognized healthcare/benefits executive with a broad knowledge of current industry trends/landscape. * Skilled presenter with ability to gain rapport quickly with various audiences and develop positive relationships. * Founder and creator of VBS, LLC, in 2005, a leader in voluntary benefits and employee benefit education. Approached/acquired in 2011 by Hub International and became the practic...

Tags for this Online Resume: Investment Services, Management, Marketing Management, Networking, New Business Development, Planning, Publications, Sales, Sales Training, Services