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Online Resumes with "Clinical Appeals"

Clinical Pharmacy Programs Manager - 20 years experience

Healthcare & Medical Resumes - Pharmacist Resumes - Plano, TX

Tags for this Online Resume: Formulary Strategizing, Analytical Data Analysis, Clinical Account Management, Plan Design Recommendation, RFP's, Medication Exceptions/Clinical Appeals, Bilingual (Spanish-speaking)

Healthcare Insurance experience--over 20 years

Insurance Resumes - Claims Examiner Resumes - Phoenix, AZ

I have been in the insurance healthcare industry for the past 20 years starting as an analyst and ending as a clinical appeal specialist. I have since gone back to school and obtain my Masters in health informatics. My interests is to change my career and take the path as a health business analyst. My claims experience will be an asset for companies that are moving forward with the integration of the EMR or EHR systems. In...

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Registered Nurse & Consultant-over 40 years experience-Seattle

Healthcare & Medical Resumes - Licensed Nurse Resumes - Seattle, WA

Dynamic, versatile Registered Nurse and Consultant with 40+ years of experience in the healthcare industry. A registered nurse with exceptional communication and consulting skills combined with a proven ability to provide counseling, patient care, and leadership to promote wellness, organization, and effective service to clients, companies, and patients. Outstanding entrepreneur and public speaker distinguished for proven l...

Tags for this Online Resume: Seattle, Nursng, Utilization Review, Clinical Appeals, Medicare & Medicaid, Education, Case Management, Regstered Nurse

Billing/Coding Specialist - 4 Years of Experience - Near 78242

Healthcare & Medical Resumes - Billing/Coding Specialist Resumes - San Antonio, TX

at Position Description: Reviewing claims working off project list or work queue. Responsible for providing expertise or general support in reviewing, researching. Experience in a production based environment with an emphasis on quality outcomes. Primary Resposabilities: * Reviewing and adjudicating medical claims in accordance with CMS claim processing guidelines. * Processing claims Up to 50K * Provide expertise claims su...

Tags for this Online Resume: Microsoft, Microsoft Outlook, Services, Adobe, Audit, Banking Industry, Benefits, Billing, Call Center, Cardiopulmonary resuscitation (CPR)

Billing/Coding Specialist - 7 Years of Experience - Near 10001

Healthcare & Medical Resumes - Billing/Coding Specialist Resumes - New York, NY

I am immensely qualified to perform the job duties expected of this role. I have over nine years of experience working in the healthcare industry. I've worked on both sides of the aisle, from advocating for international patients, to representing hospitals and reducing their aging accounts. I have experience with managed care appeals, as well as working with clinicians to get clinical appeals overturned, or paid at a lower ...

Tags for this Online Resume: Complaints, Cms, Compensation, Documentation, Insurance, Audit, CERNER, CFO, Coding, ICD-9