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Online Resumes with "Stop Loss "



Manager - 13 Years of Experience - Near 37043

Advancing toward my career goals.

Ideal Companies: Companies that work on their strengths and weaknesses.

Tags for this Online Resume: Solicitor, Human Resource, Collections, Direct Support Professional, Manager, retail manager, assistant manager, management, manager

Claims Examiner - 20 Years of Experience - Near 78754

315-492-5055 9/03-6/04-Admitting Clerk/Patient Access-Register and admit all outpatient, in patient and emergency room patients. Other responsibilities include putting together folders for pre-admission testing and surgeries running the diagnostic desk bringing patients to their rooms getting consent signatures from the nursing home floor patients assisting the charge person on duty as well as numerous tasks. 713-442-1500 8...

Tags for this Online Resume: Medical claims processor, Long term care claim processor, Austin, Medical claims

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)

MGU - Director of Operations for 3 years, TPA - VP Marketing & Reporting Services

QUALIFICATIONS: As Director of Operations, responsible for overseeing the daily operation, at the direction of the President. Additional responsibilities included interviewing potential candidates, hire, human resources support, payroll reporting, enrollment, and benefits. As VP of Marketing & Reporting Services, I reporting to carriers and clients monthly, completed client monthly, quarterly, and/or annual reviews.

Tags for this Online Resume: Cobra, Evaluate, Quality Assurance, Test, Benefits, Human Resources, Payroll, Research, Managed Care, Stop Loss, TPA, MGU, Operations, Auditor, Stop Loss,, Self funding

Insurance Underwriter - 20 Years of Experience - Near 40165

Summary of Qualifications An employee benefit professional with demonstrated expertise in the sale, underwriting and service of employee benefits plans covering Group Life, AD&D, DI, Dental, Vision, Pharmacy, HMO, PPO, POS and Indemnity Medical and Stop Loss product lines. Experienced working with internal and external partners/vendors providing comprehensive product knowledge to ensure correct product placement and account...

Tags for this Online Resume: Underwriting, Consulting, Process Improvement, Request for Proposal, Sales, Underwriter, Audit, Benefits, Actuarial, Request for Proposals

Claims Adjuster - 20 Years of Experience - Near 08520

Key Qualifications - * Proven track record of assessing benefit claims and healthcare options, including extensive knowledge of Medicare and government regulations. * Adept at developing and maintaining detailed administrative and procedural processes that significantly reduce expenses, improve accuracy and efficiency, and achieve organizational objectives. * Highly focused and results-oriented in supporting complex, deadli...

Ideal Companies: Blue Cross Blue Shield of New Jersey, Aetna Insurance Company, Horizon Blue Cross

Tags for this Online Resume: Benefits, Billing, Compensation, Complaints, Fraud, Health Insurance, Insurance, Managed Care, Anesthesia, Behavioral Health, insurance, sales, group benefits associate, marketing, health benefits broker, Health insurance adjuster

Claims Adjuster

Tags for this Online Resume: Policies and Procedures, Audit, Complaints, Crystal Reports, Services, Code Review, Coding, CSC, Deductions, Quality

Featured Profile

BUSINESS ADMINISTRATION / HEALTHCARE ADMINISTRATION PROFESSIONAL

Exceptional record of achievement in the management of healthcare programs and processes. Proven ability to streamline workflow, eliminate backlogs of work, increase efficiency, and enhancing customer satisfaction. Special expertise in in claims processing and administration, policy and procedure review, document control, and reporting. Excel at reviewing procedures and identifying strategies for improvement. Highly adept a...

Ideal Companies: Any City or State companies such as, VA or other city and State Hospitals, MTA, DMV, Social Security Administration, Housing Department, Children Services,

Tags for this Online Resume: COLLECTED SPECIMENS, Legacy, Nursing, Office Administrator, Patient Care, Wound Care, Benefits, Billing, Certified Senior Advisor, Claim Processing, Claims Manager, Great Understanding of Medical Terminology Epidemiology, Multitasking

Insurance Underwriter

Tags for this Online Resume: Management, Actuarial, Underwriter, Underwriting, Insurance, Life Insurance, Reinsurance, Financial, C Programming Language, Consulting

Database Administrator

Tags for this Online Resume: Drafting, Actuarial, Clusters, Cms, Data Analysis, Fraud, Fraud Detection, Medicare, Request for Proposal, Request for Proposals