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Online Resumes with "Commercial Managed Care"
Medical billing/follow up representative
I have 20 with Centure Healthcare in Colorado Springs. Co. I worked 10 years for Finance Dept in Accounts Payable as an Administrative Assistant/Representative. The last ten years I spent in Patient Financial Services Dept in Customer Service, Regulatory and Commercial/Managed Care Insurance Follow Up Depts. I can do anything from the front desk receptionist, pay vendor bills, maintain archived records to working patient ac...
Director, Decision Support
A Director/Management role utilizing my skills in Project Management, Medical Expense Management /Compliance Management, Strategic Planning/Market Development, Consulting/Problem solving, in order to: • Lead consulting projects and manage client relations • Reduce medical expense for commercial managed care and health insurance carriers.
Tags for this Online Resume: Hospital Compliance Officer, Six Sigma Green Belt, Medical Expense Managementt, Project Manager, Revenue Cycle Analysis, • Big Five Compliance Consultant
Admissions Director
Tags for this Online Resume: National Account Manager, Managed Care, Pharmaceuticals, Pharmaceutical Rebate Contracting, Account Management, Commercial Managed Care
Business Consultant, Benefit/Provider/Claims Configuration, Business Analyst
Twenty plus years in healthcare management and staff support roles in handling medical, claims encounter and dental claims processing, claims auditing, user acceptance testing, EMS billing, AAPC, DRG coding reimbursement, and configuration of various healthcare payers/providers for Medicare, Medicaid, TPA, and Commercial Managed Care products. Strong understanding of healthcare business operations, with a focus on configur...
Tags for this Online Resume: Telecommute, Benefit Configuration, Provider Confguration, SQL queries, User Acceptance Tester, 837p/837I XML/X12, Clearquest
Physician
Summary Healthcare Executive with over 25 years of experience in both Medicaid and Commercial managed care markets. Progressive leadership roles in financial modeling, predictive analytics, development and implementation of quality initiatives and cost-reduction programs. Acumen in strategic positioning, infrastructure development and design experienced in leading an organization through State, NCQA, and Department of Insur...
Tags for this Online Resume: PEDIATRIC, Public Health, Budgeting, Call Center, Management, Medical, Medical Affairs, Operating Budget, Quality, Quality Assurance
Customer Service Supervisor - 8 Years of Experience - Near 94534
Summary Of Qualifications Claims Team Supervisor with strong extensive experience in claims processing. I handled 30-35 examiner in a team. Responsible for Claims Processing, managing Medicare/Medicaid and Commercial insurances, capitation HMO, PPO. Responsible for non-cover claim to support staff for issuance of appropriate denial letters and/or referral to HMO. Responsible for following up on commercial and managed care c...
Tags for this Online Resume: Budgetary, Complaints, Policies and Procedures, ADA, Ada Programming Language, Team Player, Facilitator, HR, Human Resources, Management, call center
Pharmaceutical Sales Representative - 15 Years of Experience - Near 28277
A comprehensive provider of successful sales/account management/managerial leadership in the, infusion/specialty pharm arenas that offers over twenty years of comprehensive experience with all commercial/managed care and Government payer groups. A well organized and focused manager, skilled at effective leadership and team building strategies. A successful negotiator and contract implementation specialist that can handle al...
Tags for this Online Resume: Medicare, Urgent Care, Integrate, Managed Care, Management, Pharmaceutical, Oncology, Patient Care, Medicaid, Contracts, Reporting
