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Online Resumes with "Medicare medicaid "



Licensed Nurse - 17 Years of Experience - Near 33705

Summary of Qualifications: Over 17 years' of working experiences in a wide variety of clinical and administrative settings providing nursing care in Case Management, Utilization Review, Gerontological nursing, Cardiac care, Medical & Surgical units, Chronic & Infectious diseases, Public Health, Psychiatric nursing, Hospitals, Hiv clinics, LTC, Assisted living, Home health care, Biologic infusions & Marketing. * Excellent Le...

Tags for this Online Resume: Amazon Elastic MapReduce, EMR/, HIV Clinics, Home Health/ Public Health, Immunization, Wound Care/Wound Vac, Behavioral Health, Cardiopulmonary resuscitation (CPR), Chronic Diseases, CENTRAL LINES, Case Management, Utilization Review

Chief Executive Officer - 15 Years of Experience - Near 10036

SUMMARY OF QUALIFICATIONS Executive Management Skills: Effective communicator as management at an executive level with strong organizational and problem solving skills with proven abilities to liaise with various departments, institutions (providers), insurance companies, unions, and the public to raise awareness and bring support to facilities. Worked with the medical and behavioral health, care coordination and outreach d...

Tags for this Online Resume: Information Technology, Insurance contract negotiations, french, Investment Opportunities, spanish, Executive Leadership, budget Management, Medical management, electronic Medical Records, Medicare/medicaid, program development

Credit Analyst - 20 Years of Experience - Near 78112

QUALIFICATIONS Business Certifications : Underwriter/Fair Debt and Collections Act ICD-Billing and Coding Medicare and Medicaid Collections and Billing Call Center experience 25 years Management Service 32 years Speak English and Spanish fluently read and write Collections on Commercial and Goverment Contracts

Tags for this Online Resume: Management, Call Center, Audit, Billing, Coding, Customer Service, Customer Service Rep, English Language, Medicare, Underwriter, Claims Analyst

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

Director - 8 Years of Experience - Near 21740

SUMMARY Senior Director/Manager with experience leading multiple departments and disciplines and the ability to create cooperative alliances among organization leaders to support key business initiatives. Proven ability to meet goals and build and retain high performance teams by hiring, developing and motivating skilled professionals. ACCOMPLISHMENTS Managed multiple functional areas, including Quality, Communications, Tec...

Tags for this Online Resume: Assessments, Metrics, ISO, Quality, Communications, Marketing, Audit, Business Development, Clinical Programs, Legal, Hagerstown, Frederick, Martinsburg, Chambersburg, Cumberland

Director

Areas of expertise: Cross Functional Team Leadership, Process Improvement, Business Analysis, Strategy and Vendor Management DST Systems/Argus Health Systems, Kansas City, Missouri * Oct 2014 - present Director, Government Program Operations (April 2016 - present) Leader of newly formed Operations team accountable for Medicare, Medicaid and Health Insurance Marketplace (HIM) program service, quality and cost by overseeing a...

Tags for this Online Resume: Management, Project Management, Medicare, Pdp, Reliability, Leadership, Business Process Modeling, Business Requirements, Capital Planning, CIO, Operatons, Quality

Administrator - 13 Years of Experience - Near 36695

and surrounding areas throughout south Alabama. * Identify new entities to support charitable efforts and assist with outreach activities. * Works with Executive Director to produce grant proposals for clinical research. * Oversee redesign of new website and management. Lead Navigator Affordable Care Act Initiative Ascension Health/Providence Hospital Mobile AL (2013-2014) * Oversaw navigator team operations funded by Cente...

Tags for this Online Resume: Management, External Reporting, Information Technology, Contracts & Grants, Health Policy, Statistics, Healthcare Compliance, Medicaid, Affordable Care Act, Research, Writing, Policies & Procedures, non-profit, mental health, social services, Managed Care, Healthcare Quality Improvement

Featured Profile

Administrator - 10+ Years of Experience - Near 33912

I engage in team collaboration and team building to improve overall efficiencies for the organization. My ability to compile data, analyze findings, and diagnose potential problems has facilitated in the recovery of $1.9 million in qualified CMS reimbursement. I enjoy talking to people and my interpersonal skills aid in contract negotiations and allow me to develop sustaining professional relationships. I have develope...

Tags for this Online Resume: Advertising, Billing, Management, Account Management, LEAN, Financial, Financial Analysis, ROI, Services, Ecommerce, Marketing, Business Process Improvemet, Healthcare Management, Statical Analysis, Projections, Forecasting, Staff Development, Cost Analysis, Strategic Development, Project Management

Registered Nurse - 15 Years of Experience - Near 01803

Professional Summary: Able to identify and address patterns of care within varying departments - Assist in implementation of safer methods of practice. Improve patient care and/or decrease costs by developing and implementing Quality Improvement projects. Interpret statistical analyses and reformat data for the clear understanding of the intended audience. Comfortable teaching, leading or coaching groups, and individuals Ab...

Tags for this Online Resume: Medicare, Surgery, Coding, Management, Operating Room, Purchasing, Quality, Quality Assurance, Quality Management, CHF, Leader of QI Teams, Patient Safety, Boston Area, EHR, General Medical/Surgical

Case Manager - 19 Years of Experience - Near 08850

Position where my skills & abilities would be applicable to the applying position.

Tags for this Online Resume: Pre-certifications/Updating and obtaining new Authorizations, Insurance/Benefits, Management, Medicare//Medicaid Specialist, Utilization Management, Assessments, Medical Adult Day Care Center, Referrals, Community Resources, Customer Service, Project Management, Microsoft Word, Excel, Power Point

Customer Service Manager - 14 Years of Experience - Near 85041

HIGHLIGHTS OF QUALIFICATIONS: Accomplished Program Manager / Business Manager and Call Center Management Professional offering over 20 years of successful performance, proven proficiency and accomplishments in: * Senior Benefits Advisement/Consulting - Arizona State Retirement System * Healthcare / (Medicare/Medicaid) Supervisory Experience and general back ground of Appeals & Grievances - US Health Dept. * Project & Busine...

Tags for this Online Resume: Bilingual, Call Center, Customer Service, Training, Cms, Medicare, Insurance, Management, Benefits, ACD

Billing/Coding Specialist - 15 Years of Experience - Near 78641

SUMMARY Business and Information Technology professional with extensive business analysis, program/project management experience. Proven ability to lead cross-functional teams to achieve results and meet deliverables. Excellent relationship management, collaboration, presentation and communication skills across all business levels. Results- focused with strong aptitude for identifying and resolving business and technical ch...

Tags for this Online Resume: Accenture FOUNDATION, Budgeting, Business Analysis, Communication Skills, Consulting, Financial Industry, Health Insurance, Information Technology, Insurance, Integrate