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Online Resumes with "MEDICAID"
Claims Examiner
Profile Enterprising professional with 15+ years of experience executing medical insurance claims functions. Possesses expertise in insurance, health policy complaints, compliance, and regulations. Employs excellent supervisory skills and builds high-functioning teams through development of targeted training programs. Self-governing and organized, works well in a remote, work-from-home, environment. Core Strengths: Test Pla...
Tags for this Online Resume: Complaints, Documentation, Management, Quality Assurance, Test, Customer Service, customer service skills, Process Improvement, Fraud, Policies and Procedures
Quality Assurance Specialist - 4 Years of Experience - Near 90245
Professional Summary * Experience and profound understanding of Software Development Life Cycle SDLC and Software Testing Life Cycle STLC, including the following: Requirements gathering, risk analysis, project planning, scheduling, testing, defect tracking, management, and reporting. * Expertise in various Testing methodologies like Functional Testing, Integration Testing, Regression Testing, System Testing, System Integra...
Tags for this Online Resume: Integrate, Quality Assurance Tester, Test, Applications, Integration Testing, Quality, Test Cases, Test Scripts, Documentation, Its
Claims Examiner - 20 Years of Experience - Near 48235
PROFESSIONAL SUMMARY * Skilled dedicated 26 year healthcare professional with a versatile administrative skill-set developed as an office manager, claims processing supervisor, administrative assistant and quality assurance tester. * Extensive experience in resolving employer challenges with innovative solutions, systems and quality improvements proven to increase efficiency, customer service and provider satisfaction withi...
Tags for this Online Resume: Medical, Medical Records, Audit, Therapy, Training, Customer Service, Web, Coding, ICD-9, Claim Processing
Computer Programmer
QUALIFICATIONS SUMMARY Accomplished Medicaid Management Information System (MMIS) Project and Systems Manager with 20+ years Technical, Analytical, and Management Skills. * Proficient at delivering highly critical projects on time, under budget, and in scope as is evidenced by the Louisiana HIPAA project * Overall management for implementing all HIPAA-mandated initiatives for the Louisiana MMIS. Under his management, Louisi...
Tags for this Online Resume: Management, Management Information Systems, CICS, Cobol Programming Language, Cobol II, IBM DB2 Database, Structured Query Language, Team Lead, Test, Acceptance Testing
Case Manager
PROFESSIONAL SUMMARY Experienced Registered Nurse, Clinical Educator and Certified Complex Case Manager with over 30 years of experience in patient care, clinical education, unit coordination and case management. This previous experience allowed me to interface with senior hospital management in preparing/administering schedules, evaluations, patient flow patterns and daily unit activities with focus on cost reduction and q...
Tags for this Online Resume: Focus, Metrics, Quality, Quality Assurance, Management, Nursing, Patient Care, Services, Cardiopulmonary resuscitation (CPR), Communication Skills
Billing/Coding Specialist
Summary: * Well versed experience in Health Care, Health Care Administration management, Medicare/Medicaid Claims management. * Extensive Knowledge of Complex Disease Processes with Clinical experience in an Inpatient setting. * Experienced in Clinical & Experimental Research, Medical Information Retrieval and Communication. * ICD-10 Boot Camp successfully completed. * Good verbal and written communication and interpersonal...
Tags for this Online Resume: EKG, VITAL SIGNS, Imaging, Injections, Medical, Surgical, Venipuncture, Coding, Documentation, Management
Computer Programmer
QUALIFICATIONS SUMMARY Accomplished Medicaid Management Information System (MMIS) Project and Systems Manager with 20+ years Technical, Analytical, and Management Skills. * Proficient at delivering highly critical projects on time, under budget, and in scope as is evidenced by the Louisiana HIPAA project * Overall management for implementing all HIPAA-mandated initiatives for the Louisiana MMIS. Under his management, Louisi...
Tags for this Online Resume: CICS, Management, Management Information Systems, Cobol Programming Language, Cobol II, IBM DB2 Database, Structured Query Language, Acceptance Testing, IBM, IBM Mainframes
Business Analyst
SUMMARY * 10+ years of experience as a Business Analyst/Business System Analyst in industry domains including Banking, Health e, Financial, Insurance, and Retail. * Skilled Business Analyst in PMO environment who leads projects to successful completion and acts as liaison between business users and technical development teams to bridge gaps. * Strong understanding of financial valuation concepts and various capital market i...
Tags for this Online Resume: VISIO, Microsoft Visio, Business Analysis, Business Analyst, Business Requirements, Integrate, Legacy, Management, Planning, Structured Query Language
Business-to-Business Marketer
Summary Mr. Dastvar has over 29+ years of Excellence in Business Development, Client Execution, and Account Management in the technology, capital markets, Financial, healthcare, insurance, commercial and government sectors. He has developed pipeline, capture plan and strategic partnerships to drive the revenue at a corporate PAT level. He has lead targeting, growing, and developing existing and prospective client relationsh...
Tags for this Online Resume: Infrastructure, Management, Banking Industry, Business Development, Capital markets, SEC, Securities and Exchange Commission (SEC), Program Manager, Proposal Development, Recruiting
Project Manager
Professional Summary Accomplished Program/Project Manager with over 15+ years of successful launching, directing and managing of large scale programs by performing management functions such as, planning, scheduling, organizing, and tracking processes, ensuring the feasibility of each project. Worked closely with the business to define mobile app functional & technical requirements as per best practices. Directed cross-funct...
Tags for this Online Resume: Agile Methodologies, Agile methodology, Integrate, Application Development, C Programming Language, C# Programming Language, C++ Programming Language, Hyper Text Markup Language 5, Infrastructure, Microsoft
Marketing manager
KEY QUALIFICATIONS - OVER 21 YEARS EXPERIENCE IN MEDICARE, MEDICAID, AND MEDICARE-MEDICAID PLANS (MMP) Profit & Loss Accountability * Product Implementation / Mgt * Marketing & Communication Strategy * Product Strategy & Development * Business Development * Collateral / Campaign Development SUMMARY OF PROFESSIONAL EXPERIENCE CAPTIAL BLUECROSS HARRISBURG, PA 17050 SEPTEMBER 2015 - PRESENT DIRECTOR OF MEDICARE PRODUCT DEVELOP...
Tags for this Online Resume: Cms, Management, Market Research, Networking, Research, Pricing, Benefits, Marketing Management, Policies and Procedures, Product Development
Executive Assistant
I am a professional assistant with 26 years of administrative experience managing business relations and special projects at a senior management level. I have proven analytic, problem solving and organizational abilities. My skills include mentoring the administrative staff of the division, and other established general administrative requirements of the organization, while maintaining a high level of confidentiality. My go...
Tags for this Online Resume: Administrative Assistant, Benefits, Call Center, Cellular, Copy Machine, Data Entry, Disaster Recovery, Employee Relations, HP, Hub
