CV, Curriculum Vitae and Online Resumes Search

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Online Resumes with "Payers"

Billing/Coding Specialist

Ambitious and responsible professional with a proven record of accomplishment of success in positions requiring well-developed hands-on skill sets and customer service expertise. Pays close attention to detail for accurate and compliant documentation and remains committed to ensuring optimal client outcomes. KEY QUALIFICATIONS Medical Billing * Medical Coding * ICD-9-CM * ICD-10-CM * HCPCS * CPT * Medical Terminology Electr...

Tags for this Online Resume: Deposits, Point Of Sale (Pos), Sales, Quality Assurance, Test, Amazon Elastic MapReduce, Billing, Claim Processing, Cms, Coding

Billing, Posting or Calculating Machine Operator - 4 Years of Experience - Near 23320

Results oriented professional backed by cross-functional medical billing healthcare claims and accounts receivable experience. Ensures data integrity for optimal and correct reimbursement. Proficient with Microsoft Word Excel Medical Manager Greenway Realmed. KEY QUALIFICATIONS Medical Billing * Medical Coding * ICD-9-CM * HCPCS * CPT * ICD-10-CM * Medical Terminology Electronic Health Records (EHR) * Electronic Medical Rec...

Ideal Companies: Wake Forest Baptist Health, BCBS

Tags for this Online Resume: Insurance, Benefits, Credit Card, Medical, Medical Billing, Billing, Medical Records, Medical Terminology, Medicare, Microsoft

Quality Assurance Specialist - 5 Years of Experience - Near 11435

SUMMARY * 6 plus years of experience in Manual of Web, Client Server applications. * Expertise in writing Test Plans, Test Scenarios, Test cases, executing Test cases and logging Defects found. * Experience with Test Case Management using HP Quality Center/ALM. * Strong understanding of SDLC phases and models. Good Knowledge in Software Testing Life Cycle and Defect Life Cycle. * Worked on Agile and waterfall methodologies....

Tags for this Online Resume: EDI, Electronic Data Interchange, Health Insurance Portability And Accountability Act, Extensible Markup Language (XML), HP, Oracle, Test, Test Plan, Microsoft Windows, Test Cases

Physician - 10 Years of Experience - Near L4J 2

& EXPERIENCE and other key HTA countries and communicated with payers or relevant HTA review organizations for Xtandi (enzalutamide) Myrbetriq (mirabegron) Vesicare (solifenacin) Prograf (tacrolimus) and Advagraf (tacrolimus extended release) I supported oncology urology and immunology therapeutic areas by providing expertise and generate clinical and economic data to support the medical value of Astellas products * I devel...

Tags for this Online Resume: Networking, Research, Accounting, Assessments, Benefits, Cardiovascular, Clinical Research, Consulting, Evaluate, Immunology

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

Manager Business Analysis & Consulting - 12 Years of Experience - Near 91367

SUMMARY solutions, skilled in Business Analysis, Consulting & Solution Design BUSINESS ANALYSIS & CONSULTING * Consulting various Healthcare Payer organizations PBMs RCM organizations on detailed process analysis automation opportunities & findings developing automation roadmap cost benefit analysis (CBA) piloting process automation interventions focusing on quicker resolution efficiency improvements and reduce cycle time o...

Tags for this Online Resume: Business Analysis, Consulting, Management, Business Analyst, Information Technology, Program Management, Program Manager, Project Management, Project Manager, C Programming Language

Business Analyst - 10 Years of Experience - Near 07054

SUMMARY * 10 years of experience across multiple clients and different industries primarily in Healthcare, Pharmaceuticals and Hi-Tech. * Business Analyst with over 5 years of experience supporting business solution software and analyzing business operations. * Life Sciences and Healthcare vertical: Expertise on Payer / Plan Reimbursement functions, Master Data Management on Data Warehouse, Platform design / implementation ...

Tags for this Online Resume: Documentation, Business Analysis, Business Analyst, Management, Pain Management, Predict, Predict (Data Dictionary), Underwriter, Structured Query Language, Systems Analysis

Tester - 14 Years of Experience - Near 92121

Experience Summary Overall 15 years of Total Experience in the IT Industry, and 5 year of Experience in Syntel * Very strong Domain knowledge in Health Care * Hands on knowledge in FACETS Application (Member, Plan/Product, Provider, Eligibility & UM) * Working experience on Agile testing methodology. Acting as Scrum Master. Organize Sprint planning meeting, Daily Scrum Meeting, Creating Sprint report, Create task to the tea...

Tags for this Online Resume: Consulting, Quality Assurance, Structured Query Language, Test, Cognos, Health Care Industry, IBM, Script, System Testing, Test Cases

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

Chief Executive Officer - 20 Years of Experience - Near 32533

Tags for this Online Resume: Behavioral Health, Consulting, Health Care Industry, Networking, PEDIATRIC, Commercial Insurance, Management, Network Management, Provider Reclations, Medicare, Medicaid, Provider / Payer Contracting, Business Development, EAP Networks, Business Consulting

Medical Office Manager

Summary As an experienced, innovative, strong & creative leader among my accomplishments are: * Maximizing operational efficiencies & reducing costs while assuring quality & customer satisfaction. * Designing databases, analytic models & reporting to identify & quantify opportunities to increase profitability spread "best practices" & improve service. * Perform numerous database analytics to quantify critical metrics. * Sav...

Tags for this Online Resume: Benefits, Complaints, Managed Care, Services, Billing, Provider Operations, Long Term Care, Medicare, Transportation, Account Management, Revenue Cycle, Contracting, Network Development, Provider Relations, Management

President - 15 Years of Experience - Near 60564

CAREER SUMMARY Results driven leader with twenty years of experience in healthcare, including executive leadership roles the past nine years. Strong knowledge of value based reimbursement models, population health management, clinically integrated networks, managed care payers, and post-acute care providers. Strategically develop business plans, relationships, and distribution channels to enhance market competitiveness. Pro...

Tags for this Online Resume: Leadership, Executive, Strategy, Distribution, Management, Development, Profitability, Managed Care, Account Management, Acquisitions, Optimization, P&L, healthcare, managed care payers