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Online Resumes with "Review medical records"
Legal Nurse Consultant/Nurse Paralegal- 20 Years of Experience - Near 33547
Provide medical expertise and quality materials to assist attorneys with review of medical records so that attorneys can focus on legal issues.
Tags for this Online Resume: Tampa Bay, Fl, Cleveland, OH, Legal Nurse
Physician executive strong CM/UM experience, demonstrated ability to avoid readmission and increase claims efficiance - near 60637/430
Experienced medical professional, expert in adult and geriatric medicine, care coordination that avoids unnecessary readmission,chronic disease management (including home visits,) Medicare, it's managed care partners and dual eligible,managed care administration, medical education, and clinical practice. Committed to empowering providers and utilization/care management nurses to fully partner with payors and health systems ...
Ideal Companies: BlueCross/BlueShield, Medicare, Anthem, Cigna, United Health Care, CMS, Presence, Valence
Tags for this Online Resume: Geriatrics, Chronic disease management, Utilization/Care Management, HIPAA/Clinical Medical Ethics, HealthCare Professional Education, clinical policy development, Physician, Director, Medical Director, Physician Executive, Adult Medicine, Geriatric Medicine, Care Coordination, Population Health, Dual Eligibility Systems, Risk Management, Medical Education, Multidisciplinary Education, Clinical Ethics Training, Medical Ethics, Oral Communication, Written Communication, Social Media, MS Office, MD, FACP, AGSF, Underwriting, Claims, Non Profit, Principle
Case Manager - 18 Years of Experience - Near 32803
Professional Summary Accomplished and energetic Case Manager with a solid history of achievement in Short Term Disability and Workers Compensation. Motivated leader with strong organizational and prioritization abilities. Areas of expertise include Short Term and Long Term Disability, Review of medical records and analysis of medical records to make determinations.
Tags for this Online Resume: Insurance, Compensation, Microsoft Windows, Appeals, Life Insurance, Orthopedic, Operating Room, Assessments, ENT, Disability Claim
Claims Adjuster - 7 Years of Experience - Near 32757
Summary Demonstrated achiever with exceptional knowledge of business administration, management and business processes Strong analytical, customer service and time management skills * Ability to learn new concepts quickly, works well under pressure, works well in ever changing environments, ability to meet stringent deadlines * Extensive computer knowledge, including knowledge of multiple networking environments and busines...
Tags for this Online Resume: Accounts Receivable, Arbitration, Billing, Business Software, Coding, Customer Service, Fraud, Fraud Detection, ICD-9, Insurance
Billing/Coding Specialist
Professional Summary: 25 years' experience as a Clinical Nurse Auditor and 15 of those years as a Regional Manager. Regional manager of 14 hospitals with 20 employees. Expertise in reviewing medical records and identifying lost revenue for facilities. Coordination of department managers and facilitate course of actions to improve documentation. Familiar with commercial and private insurance carriers and educated the staff o...
Tags for this Online Resume: Audit, CFO, Documentation, Protocol, AR, Billing, Health Insurance Portability And Accountability Act, Hospital Administration, Insurance, Inventory
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
Licensed Nurse/HEDIS - 14 Years of Experience - Near 75154
Summary: LVN in Texas with 12 years of professional nursing experience. Experienced performing HEDIS abstraction and performing quality audits. Comfortable and experienced traveling as a HEDIS nurse and is open to overnight travel. Round out my experience by being a subject matter with experience in CMS Star Measure Programs. HEDIS Nurse (Contract) Cigna/Kaztronix, McLean, VA 03/2016 - present * Provided quality site review...
Tags for this Online Resume: Documentation, Medicare, Nursing, Medical, Medical Records, Audit, Home Health, Quality Assurance, Cms, Management
Court Clerk - 2 Years of Experience - Near 07801
Career Summary Detail-oriented and organized Data Entry clerk/medical billing extensively trained in Medical Records/Chart method payment posting, coding CPT- ICD 9-10 over 7 years' experience doing multiple data entry duties, focused on delivering high quality results in a timely manner. Have skills in reviewing medical records and releasing information by HIPAA law and process and submitting medical claims.
Tags for this Online Resume: Insurance, Amazon Elastic MapReduce, Coding, EMR, Medical, Medical Records, Customer Service, customer service skills, Billing, CCA, customer service, administrative assistant, telecommute, sales, medical records, imaging clerk, payment posting
Case Manager - 6 Years of Experience - Near 10031
Accomplishments are: - Ongoing training in Inpatient Utilization Procedures to audit and review medical records - Conduct on-site/off site review of medical records for quality of care and utilization. - Review process including DRG validation and Interqual criteria approval. - Utilized review criteria with the use of InterQual, 3M coding book and grouper, SIMS Plus. - Increased knowledge base on medical comorbidities in ad...
Tags for this Online Resume: Infrastructure, Support, Technical Support, Services, Public Health, Reviews, Quality, Acquired Immune Deficiency Syndrome (AIDS), physical therapist
Licensed Nurse - 20 Years of Experience - Near 78382
To be employed in a company that will allow me to use my skills as a nurse, and to use the knowledge that I have gained in the disease management, home health field as well as my experience as a clinician, and to also be able to use my managerial skills as well as marketing skills. QUALIFIED BY: I am a dedicated nurse seeking full time employment. I have performed Community Education/marketing/liaison work, home health, I h...
Tags for this Online Resume: Support, Wound Care, nurse
Registered Nurse - 20 Years of Experience - Near 07601
RESUME Summary: Professional Nurse with more than 15 years of experience in a leadership position in a Magnet hospital and other healthcare organizations. Possesses excellent clinical and administrative skills, i.e. organization, recruitment & retention, problem-solving with corrective action planning, staff development, coaching/mentoring, performance evaluation, utilization review, medical records review, budget planning,...
Tags for this Online Resume: registered nurse, healthcare, Leadership, Payroll, Performance Evaluations, Scheduling, Administrative Skills, Budgeting, Coaching, Health Care Industry
Billing/Coding Specialist
PROFESSIONAL SUMMARY Medical Billing Specialist and Medical Administrative Assistant with 18 years of experience supporting multiple physician specialists in a busy Nephrology practice. Responsibilities include insurance credentialing for all physicians verifying insurance coverage, reviewing medical records to translate into ICD10 codes, obtain prior insurance authorizations and using Medics to post medical charges of hosp...
Ideal Companies: private physicians, hospitals , clinics
Tags for this Online Resume: Coding, Documentation, Filing, Insurance, Medical, Medicare, Microsoft Office, Microsoft Word, Nephrology, Software
