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Online Resumes with "Medical Claims"
Claims Investigator - 10 Years of Experience - Near 07823
PROFESSIONAL SUMMARY: Core Qualifications: * Proficient in data management, web applications, Microsoft Office suite including Excel, Power Point, Publisher, Adobe Suite and other specialty specific software applications * Accomplished in medical claim verification of coverage, denial and appeal processes * Facile in coordination of post-acute care patient needs * Skilled in all aspects office management, including scheduli...
Tags for this Online Resume: Denials, Billing, Claims, Financial Services, Compliance, Managed Care, Recoupment, Investigation, Insurance, Appeals, Regulations, Hackettstown, NJ
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
Claims Examiner - 10 Years of Experience - Near 30052
Summary of Qualifications Twenty-Five years of progressive experience in the health insurance industry. Extensive knowledge of reimbursement methodologies, claims payment analysis, quality assurance. Proven ability to effectively resolve issues through superior customer service techniques and analytical skills. Ability to prioritize and multi-task to achieve productive outcomes. Proficient operations of QCARE and ACARE clai...
Ideal Companies: anthem
Tags for this Online Resume: medicare/medicaid, medical claims, claims adjuster, customer service, hospital, professional, Acceptance Testing, Clarify, COB, Documentation, Health Care Industry, Inventory, Medicare
Customer Service Representative - 20 Years of Experience - Near 76119
QUALIFICATIONS Dedicated insurance professional with more than 20 years of experience as an inbound/outbound customer service agent, claim re-price representative and effectively managing multiple high priority projects. 10 years of experience as a medical office receptionist with knowledge of various medical insurance payers Experience using proprietary medical claims processing software/applications Strong organizational,...
Tags for this Online Resume: Health Insurance Portability And Accountability Act, Protocol, Billing, Insurance, OB/GYN, Pediatrics, Surgery, Urgent Care, Customer Service
Medical Office Manager - 20 Years of Experience - Near 75115
Professional Summary Led within the Healthcare Industry specifically as it relates to electronic and medical claims billing. Over past three years, directly responsible for maintaining data records and submitting $100M in electronic claims monthly Analysis with extensive experience in Electronic submission. Proficiencies include claims, customer service and reporting. Core Qualifications Electronic Billing Experience * Prof...
Tags for this Online Resume: Cognos, Payerpath, analytical, Works well with all levels, Excel, Systems Analyst, ANSI, Ansi (Am Natl Stds Inst), Billing, Documentation
Pharmacist - 4 Years of Experience - Near 11004
Experienced with hormone replacement therapy, thyroid therapy, and veterinarian medications Used knowledge of sig codes, drug information, and compounding calculations to accurately enter and fill prescriptions Entered patient files and assisted in completing medical claims into the data system for timely processing Provided exceptional customer service and patient counseling regarding medications INTERNSHIP CLINICAL ROTATI...
Tags for this Online Resume: Patient Counseling, Therapy, Customer Service, Drug Information, Medical, Inventory, Patient Care, Pricing, Cardiopulmonary resuscitation (CPR), Family Practice
Admissions Director
Summary of Qualifications * Possess expertise in managing daily operations of Hospital Admissions and Information departments, Emergency Room Registration, medical office records and operating expenses. * Experienced in performing annual performance evaluations for department personnel and supervisory staff. * Successfully prepared hospital departments for audits and reviews, which resulted in 100% passing rates. * In depth...
Tags for this Online Resume: College Educator: Bio Sci, Medical record documentation, Analytical, Practitioner/Practice management, Emergency Room Regristration, Medical Claims Adjudication, Director of Admissions, Diagnostic & Treatment Coding, Washington DC - Metro area, Managed Care
Medical Records Technician - 8 Years of Experience - Near 85022
Summary of Qualifications * 5 yrs enrolling International/Domestic students for Distance learning * 4 yrs as Office Manager / Warehouse Manager * 8 yrs of experience working in Health Information Management * Ability to maintain confidentiality of sensitive information for customers and employers * Work and communicate effectively with management and people of diverse backgrounds * MS Excel MS Word MS Outlook Power Point E-...
Tags for this Online Resume: Medical, Medical Records, Apollo, Problem Solving, Problem Solving Skills, Management, Accounts Payable, Accounts Receivable, Advertising, Data Analysis, healthcare administration
Medical or Health Services Manager - 20 Years of Experience - Near 33534
SUMMARY * 15+ years' experience as a clinical professional with a broad range of healthcare experience, talent and expertise also in Medicaid claims reviews programs * Extensive nursing experience in multiple areas (Utilization Review/Managed Care including Inpatient/Outpatient service for Pre-Cert, Concurrent Review, Case Management, Medical Claim/Bill Review, ICD-9/ICD-10 Coding, Hedis Reviews, Home Health Care, School Nu...
Tags for this Online Resume: Medicare, Computer Aided Software Engineering, Management, Injections, Insurance, VITAL SIGNS, Medication Administration, Nursing, Wound Care, D.O.D., Case Manager, Billing, Coding, Auditing, Utilization Review, Manager, Supervisor, Health Services, Nurse, LPN, Trainer
Billing/Coding Specialist - 4 Years of Experience - Near 78242
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)
Medical Records Technician - 10 Years of Experience - Near 60652
Professional Summary Experienced professional offers the following key strengths: 10 years plus experience in diverse settings. Thorough knowledge of Current Procedure Terminology (CPT), ICD-10 Coding, Revenue codes, and UB92 and 1500 Medial claim forms. The industry and technology trends as applied to patient account management Medicare, Worker compensation, Blue Cross, and Commercial Insurance billing and collections. Pro...
Tags for this Online Resume: Benefits, Management, Medical, Accounting, Audit, Compensation, Distribution, Financial, Financial Industry, Financials
Business Analyst - 7 Years of Experience - Near 37209
Professional Summary * Over 8+ years of diverse experience as a Business System Analyst in developing and implementing innovative business processes. * In-depth knowledge and experience in full SDLC with RUP, agile and waterfall methodologies. * Functional experience in health Care Industry with vast knowledge on Medicare and Medicaid. * Expertise in creating the companion guides on various EDI transactions. * Specialize in...
Tags for this Online Resume: Management, Structured Query Language, Business Requirements, Microsoft Visio, Oracle, Use Cases, VISIO, Business Analysis, Business Analyst, Health Insurance Portability And Accountability Act, agile, software, html, c++, sql, medicaid, CMS, HIPPA, Testing
