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Online Resumes with "Payers"
Director, nationwide
I am a senior healthcare executive with extensive experience leading managed care contract negotiations and operations in Medicaid, Medicare and commercial markets. I have most recently held the position of Director, Provider Reimbursement for Presbyterian Health Plan located in Albuquerque, New Mexico in which I managed a staff of eleven Network Development professionals in negotiating contracts for all provider types a...
Tags for this Online Resume: Director of Network Management, negotiate contracts, manage people, reimbursement expert, provider relations, network development
Clinical Data Management - 7 years Experience
Proficient in the patient accounting systems. Experience with patient accounting and provider/hospital billing, contract management and payer/provider terms (DRG, multiple procedures, etc). Working knowledge of billing forms (UB, HCFA, etc), claim coding (HCPC, CPT). Proficient knowledge of SMS, STAR and other multiple payer websites and billing systems. Excellent in collecting, analyzing and processing data. Proficient kno...
A talented and highly motivated business professional seeking a full-time Insurance claims Adjuster position.
A talented and highly motivated business professional seeking a full-time Insurance claims Adjuster position. my vast knowledge in the areas of cost control measures, my timeless handling of claims, identification of injuries and exposure of appropriate coverage, able to interpret and apply concepts of law, contracts, case law, company policies and procedures in compliance with state regulations, these are some of the skil...
Ideal Companies: Allstate, Geico, AIG, Prudential, All insurance carriers and 3rd party Administrator
Tags for this Online Resume: •Economic/Financial Analysis•Risk Assessment/Management•Statistical/Business Analysis •Accounting/Financial Control•Asset Protection/Management•Comparative Economic Systems •Strategic Planning/Execution•Solutions Consulting•Business Proc
Director of Professional Services- Healthcare
Healthcare management within the hospital, provider, third party payer environment
Admissions Director, Pittsburgh
Over fifteen years of diversified healthcare management experience successfully directed staff of 30+ and am a seasoned team oriented leader with fair and consistent management style. I have a strong background in department operations and strategic planning, excellent communication and organizational skills. Adept in team dynamics, conflict resolution, training and development and Human Resource procedures. Continually mai...
Tags for this Online Resume: Director, Business Office, Meditech, Pre-Service Center, Call Center, Revenue Cycle, Insurance
Sr. Medical Billing Representative
Highly Skilled Accounts Receivable Representative with over 15 years’ of medical and business billing experience. Proven expertise working with patients to resolve Medicare / Medicaid denials and submit appeals. Skilled at medical coding, medical billing, processing medical claims, and performing insurance research.
Ideal Companies: Hospital
Tags for this Online Resume: Billing Coding, Medical Terminology, Collections, Office Administration, Data Entry, Medical Coding, HIPPA Standards
Director, Strategic Planning & Decision Support
I am seeking a position with a healthcare organization that will benefit from my experience in the following areas within both the healthcare provider and payer market segments: • Client Engagement • Healthcare Strategic Planning and Analytics • Business Intelligence • Population Health Strategic Planning/Implementation • Systems Integration • Hospital/Clinical Process Transformation • Large Team Leadership and Program Ma...
Tags for this Online Resume: Healthcare, Director Clinical Quality Management, Market Research Director HealthCare , Director of Analytics & Insights, Strategic Planning Manager healthcare, Director Decision Support Healthcare, Healthcare Research Manager, Director of Operations Healthcare, Healthcare Market Analyst, Director of Strategic Planning Healthcare, Business Development Manager Healthcare, Director of healthcare quality/Risk Management, /Manager Clinical Quality Management, Market Research Manager HealthCare , Manager of Strategic Planning Healthcare, Manager of healthcare quality/Risk Management, Clinical , Population health, Electronic Health Record, Clinical integration, Verisk analytics, medecision, Healthcare provider network management, patient registry, Physician Performance measurement, Physician Pay for performance, value based reimbursement, Physician Quality and cost measurement, ACO analytics
Dynamic Director of Operations - 15 years of experience
Dynamic Maintenance / Operations Manager with over 15+ years of experience in business processes, operations, start-up and Original Equipment Manufacturing, seeking employment in an environment that pushes the current limits of my abilities and allows the opportunity to gain the respect of my peers. Possesses proven management abilities handling 24/7 operations with both fixed and rolling assets. Solid industrial, transport...
Ideal Companies: Automotive, Manufacturing, Service, Aerospace
Tags for this Online Resume: Six Sigma Black Belt , PMP / PMI / Kepnor Tregoe , QS and ISO-9001 , Plant Manager , Project Manager , DMAIC, DFSS, DFM, Microsoft Project, Project Plan, Cost Estimates, Contracts, Engineering Management, Change Management, Cost/ Benefit analysis, Cost Accounting, Internal Controls, Consulting, Strategic Planning, Safety and Environmental Management, Needs Assessment, Market Analysis, Safety Environmental, Quality, Performance Management, Risk Management, Inventory Management, Customer Relations, Vendor Relations, Regulatory Compliance, Tactical Planning, Team Leadership, Benefits Analysis, Payroll, Reporting, Recruiting, International Business, ERP and IT Infrastructure, Shop floor integration, APQP, Director of Operations
Administrator for Home Health Agency for 14 years. Have been Director of Quality improvement
I am a Registered Nurse with Administrative and Management skills over the past 24 years. I have extensive knowledge regarding Medicare/Medicaid and Medicare Advantage Plans. Have negotiated with Insurance Agencies for contracts and reimbursement. Have hired, oriented, and have been responsible for staff development and education. Was responsible for supervision of all disciplines in health care including RNs, LPN, Cert...
Ideal Companies: Blue Cross Blue Shield, United Health, Molina Health, Humana, Aetna, Home Health and Hospice Agencies, Case Manager Companies
Senior Physical Therapist-26 years of experience-Advanced Clinical and Management Skills
I am a Physical Therapist who has over 20 years of evidence based sound clinical skills and management experience which includes program development,community outreach and implementation/revision of electronic medical record to correspond with third party payer requirements.
Tags for this Online Resume: Physical Therapist, Naples Florida
Director Revenue Cycle Management/Ancillary Services
I am a healthcare administrative professional with over 6 years of experience in healthcare management and financial management. I have been a project manager, software implementation and training as well as provided consulting for healthcare financials.
Tags for this Online Resume: Health Information Administration, Third Party Payer, Leadership, Consulting, Medical Billing, Meaningful Use
Health Care Surveyor Investigator
Extensively experienced and dedicated OTR/L offering more than twenty years of management experience; history of work experience in geriatrics, adults, pediatrics, mental health, acute care, out-patient, traumatic brain injury, and home health. Substantial knowledge of Medicare and Medicaid regulations, as well as a working knowledge of third party payers.
Tags for this Online Resume: healthcare, manager, Medicare, skilled nursing, acute care, director
