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Online Resumes with "Grievance"
Registered Nurse - 20 Years of Experience - Near 95670
Career Summary: Over 20 years of experience in Acute Care and Health Service programs including Utilization Review, Provider Dispute Resolution, Quality Management, Inpatient and Ambulatory Case Management, and Grievance and Appeals in a managed care environment for both Health Plan and IPA/MSO settings using evidence based nationally recognized criteria such as ACOG, NCCN, MCG, InterQual and Health Plan Medical guidelines ...
Tags for this Online Resume: Compliance, Management, Quality Management, Assessments, Medical, Medicare, registered nurse, healthcare, Managed Care, Utilization Management
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
Manager - 15 Years of Experience - Near 77478
Accomplishments on this Assignment: * Analyzed Organizational Effectiveness and partnered with leaders to Increased Employee Engagement by facilitating coaching skill building activities that created a high performing culture through commitment and accountability. Increased Front Line Leaders skills and level of engagement through successful coaching and Development approach. This effort contributed to high performing teams...
Tags for this Online Resume: HR, Human Resources, Management, Training, Workforce Planning, Arbitration, Bilingual, Change Management, Coaching, Talent Management, HR Generalist, Employee Relations
Quality Coordinator - 20 Years of Experience - Near 11590
Professional with 15+ years of experience in the healthcare industry. Seeking a challenging opportunity with growth potential within an expanding organization where I can utilize my years of reimbursement, collection and Appeals/Grievances experience with outstanding interpersonal, communication and organizational skills. NORTHWELL HEALTH, CARECONNECT A&G Investigator - Greenvale, NY - January 2017 - present * Facilitates m...
Tags for this Online Resume: INTAKE SUPERVISOR, PATIENT FINANCIAL REPRESENTATIVE, REIMBURSEMENT MANAGER, REIMBURSEMENT SPECIALIST, CUSTOMER SERVICE MANAGER, Analytical Skills, Billing, CMM (Capability Maturity Model), Coding, Communication Skills
Claims Examiner - Medicare Appeals&Grievance SME - Near 85249
Tags for this Online Resume: group health benefits, investigator, insurance
Executive Secretary - 20 Years of Experience - Near 60417
SUMMARY SKILLS EXPERIENCE 02/1997 to Current 04/1991 to 01/1997 12/1989 to 03/1991 HUNT IL 60417 H: (708) 672-0623 C: (708) 308-2507 vhunt@govst.edu Dedicated Team Player Advanced MS Office Suite Self-starter knowledge Self-directed Meeting planning Professional and mature Schedule management Administrative Secretary Governors State University - University Park, IL Responsible for providing support and managing daily calend...
Tags for this Online Resume: Accounts Payable, Acquisitions, Administrative Assistant, Human Resources, Management, Microsoft Office, Schedule Management, Shorthand, Team Player, administrative, administrative assistant
Human Resources Manager - 20 Years of Experience - Near 53090
Versatile Human Resources Leader with consistent success fulfilling the needs/challenges of dynamic employers. Aligns workforce initiatives with business objectives and promotes accelerated decision making through building trusted managerial and employee relationships leveraging proactive communications/ coaching and solid business judgment using factual/quantitative analysis. Strengths include: recruiting training salary/b...
Tags for this Online Resume: Human Resources, Integrate, Benefits, Recruiting, Appraisals, Occupational Safety and Health Act, OSHA, OSHA Regulations, Payroll, Security, employee relations, benefits
Industrial Production Manager - 15 Years of Experience - Near 84081
I am able to focus on employee's positives and use them to create and motivate for great moral all through the work place. . I organize develop and manage employees in a positive open communication work place and provide timely feedback after reviewing all recommendations and questions. . I take responsibility for the implementation and compliance of company polices performance objectives individual development and all grie...
Tags for this Online Resume: Spring, Cardiopulmonary resuscitation (CPR), First Aid, management, manager, assistant manager
Consultant - 15 Years of Experience - Near 33547
SUMMARY of QUALIFICATIONS: * Over fifteen years on hands experience leading and performing HR duties at professional levels, working closely with executive Management supporting different business operations. * Ability to provide comprehensive Human Resources support elements into the business strategy and operational plans. * Provides solutions, regarding organization design, change management, training& development, talen...
Tags for this Online Resume: Human Resources, Audit, Compensation, Oracle, Payroll, SAN (Storage Area Network), Statistics, Support, Workers Compensation, Benefits
Operations Manager - 20 Years of Experience - Near 82935
SUMMARY Technically adept business leader with over 20 years driving success in operations and supply chain optimization, implementation of best practices and process improvement methodologies, and human capital development. Proficient in all phases of operational performance, including process selection and design, continuous improvement, root cause analysis, lean production and the theory of constraints. Forge productive ...
Tags for this Online Resume: Best Practices, Budgeting, Capacity Planning, Cross-functional Team Leadership, Evaluate, production, reliability, "project management", manufacturing, production manager
Human Resource Labor Relationship Specialist - 20 Years of Experience - Near 77002
To obtain top level position in the industry, where I can use my strong analytical, detail oriented and interpersonal skills along with my knowledge and experience to improve productivity and efficiency in achieving the set goals of the company.
Tags for this Online Resume: HR Planning , Recruitment , Compensation Management, Performance Appraisal, Retaintion , Grievance Handling/Industrial Relations, Health, Safety , Organizational Development, 5S, Accenture FOUNDATION, Head of HR/ HR/Recruitment Consultant
Director of Human Resources - 20 Years of Experience - Near 92620
Areas of Expertise Employee Relations * Grievance/Conflict Resolution * Payroll - ADP & Paycom * Liaison / Negotiation Practices HRIS - Paycom & Ceridian * Training and Development * Federal/State HR Practices * Transition Management Policy Development * Organizational Development * EEOC Compliance * Multi-site/state Expert Career Highlights Cal-Work Safety, Irvine, CA 2016 - Present Human Resources Business Partner * Diagn...
Tags for this Online Resume: Management, Acquisitions, Complaints, Compliance, Fraud, Insurance, Litigation, Training, Employee Relations, Appraisals, human resources, hr, employee relations, payroll, benefits, staffing, customer service
