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Online Resumes with "TPA "



Business Consultant, Benefit/Provider/Claims Configuration, Business Analyst

Twenty plus years in healthcare management and staff support roles in handling medical, claims encounter and dental claims processing, claims auditing, user acceptance testing, EMS billing, AAPC, DRG coding reimbursement, and configuration of various healthcare payers/providers for Medicare, Medicaid, TPA, and Commercial Managed Care products. Strong understanding of healthcare business operations, with a focus on configur...

Tags for this Online Resume: Telecommute, Benefit Configuration, Provider Confguration, SQL queries, User Acceptance Tester, 837p/837I XML/X12, Clearquest

Featured Profile

Senior Medical Claims Examiner - 15 Years of Experience - Near 33173

I strongly believe my record as Senior Medical Claims Examiner as well as my Certificate in Medical Billing could be suitable for any position you have related to those skills above mentioned. I have 15 plus years of experience in Health Claim Field for a Medical Insurance T.P.A (Third Party Administrator) in Miami, Florida and, as my enclosed resume illustrates. My line of work in my present job is not only the analysis ...

Tags for this Online Resume: Billing, Coding, Data Processing, Hudson, Medical, Medical Billing, Medical Claims Examiner, Benefits, COB, Medicare

Claims Adjuster - 5 Years of Experience - Near M6E 2H6

Qualification Summary : B.H.M.S - Bachelors of Homoeopathy In Medicine & Surgery. Has knowledge of Homoeopathy as well as Allopathy medicine with all medical terminology. 3 years and 4 months experience as a claim adjuster in Raksha TPA Pvt. Ltd. i.e. Third party administrator company settling mediclaims (Health insurance claims) on behalf of government insurance companies. 2 years experience as a medical officer in a hospi...

Tags for this Online Resume: Audit, Fraud, Insurance, Management, Medical, Vitals, Communication Skills, Government, Health Insurance, Insurance Claims

Biologist - 16 Years of Experience - Near 400615

Profile I am ambitious and driven professional with extensive knowledge of small molecule drug discovery. Have strong scientific background in inflammation and pain area with a new technical and conceptual idea. Have extensive knowledge and expertise in preclinical in-vivo efficacy models of asthma, chronic obstructive pulmonary disease, lung fibrosis, rheumatoid arthritis, inflammatory bowel disease, psoriasis and pain in ...

Tags for this Online Resume: Coaching, Collection, COPD, Evaluate, Integrate, Pharmaceutical, Pharmaceutical Industry, Preclinical Pharmacologist, CFA, Chemistry

Admissions Director

QUALIFICATIONS * 20 year record in sales, training, operations, and insurance experience in market strategies, selling techniques, public speaking, recruiting, management, and training. * A proven sales leader and team player dedicated to results and customer service with clients/ referral sources. * Proven Health Care Sales and Marketing Experience in Home Health, Skilled Nursing, Acute Rehabilitation, Hospice, and Behavio...

Tags for this Online Resume: Home Health, Hospice, Managed Care, Referrals, Skilled Nursing Facility, Integrate, SOC, CHF, COPD, Medicare, Tucson,, Sales and Marketing, Behavioral health, Insurance, 5 Star, HEDIS

Insurance Sales Manager - 20 Years of Experience - Near 16066

Career Summary Vice President, Neace Lukens, 2007 to 2015 - Facilitated the insurance brokerage firm's expansion into PA with a focus on generating new business both organically and via acquisition. Includes full suite of employee benefit and risk management products and services for commercial accounts. Also responsible for the successful ongoing management of client accounts. Executive Vice President of Sales and Marketin...

Tags for this Online Resume: Account Management, Budgeting, Business Plan, Business Strategies, Business Strategy, Customer Accounts, Financial, Financial Services, Focus, Insurance

Claims Adjuster - 18 Years of Experience - Near 75243

Experienced with Value Stream and Process Mapping. Implemented and managed the revised total loss program, in the Irving and Denver Liberty offices. Achieved significant improvements on rental, storage and salvage processing times. Experience handling Third Party Liability losses for both Operations and Completed operations for Construction, Manufacturing, and Auto Repair facilities as well as other accounts. Managed claims...

Tags for this Online Resume: Management, Property Management, Risk Management, Construction, Customer Service, Manufacturing, Quality, Quality Assurance, Reviews, Training

Chief Executive Officer

Profile: * An accomplished and recognized healthcare/benefits executive with a broad knowledge of current industry trends/landscape. * Skilled presenter with ability to gain rapport quickly with various audiences and develop positive relationships. * Founder and creator of VBS, LLC, in 2005, a leader in voluntary benefits and employee benefit education. Approached/acquired in 2011 by Hub International and became the practic...

Tags for this Online Resume: Investment Services, Management, Marketing Management, Networking, New Business Development, Planning, Publications, Sales, Sales Training, Services

Claims Examiner - 20 Years of Experience - Near 33596

Professional Summary * Extensive experience handling commercial/residential claims. * Creative and analytical thinker with strong strategic and execution track record. * Outstanding problem-solving and crisis management skills. * Superior management, training, interpersonal and communication skills. * Developed Catastrophe Recovery plan for training TPA adjusting firms.

Tags for this Online Resume: CAT, MRP, Opal (Data Def. Lang), Arbitration, Training, Insurance, Analytical Thinker, Appraisals, Communication Skills, Management, Claims Examiner

Senior Vice President - 20 Years of Experience - Near 77379

initiatives in the healthcare industry. Intuitive leader with acute business skills and expertise in healthcare programs and market penetration. Extensive experience in managing all client and vendor/partner rela- tions and skilled in developing equipping and empowering teams of staff in a multi-line health plan of over 300,000 members. Experienced in Customer Service/Call Center and Claim Operations manage- ment of high vo...

Tags for this Online Resume: Compliance, Behavioral Health, Configure, Management, Receivables, Claim Processing, Cobra, Planning, Policies and Procedures, Strategic Planning, management, strategic planning, staff management, production management, staff training and development