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Online Resumes with "adjudication"



Quality Coordinator - 19 Years of Experience - Near 60077

SUMMARY * Over 18 years experience in a healthcare environment, with skills ranging from claims adjudicating, workers's compensation. * Extensive experience auditing claims and contracts.

Ideal Companies: VA, Blue cross blue shield, AON

Tags for this Online Resume: Audit, Pricing, Quality Assurance, sheets, Surgery, Test, Billing, Compensation, Complaints, Workers Compensation

Claims Adjuster - 20 Years of Experience - Near 21015

SUMMARY Insurance professional with extensive experience in adjudicating claims for both individual and group policies. Claims handling involved a variety of products including: Life, AD, Disability, Credit Insurance, HIP, Med Supp, etc. Highly adaptable, strong interpersonal skills, demonstrated abilities in working closely with claimants, attorneys and regulatory agencies to resolve complex issues and complaints. Expertis...

Tags for this Online Resume: Compliance, Insurance, Benefits, Complaints, Customer Service, Microsoft, Microsoft Excel, Microsoft Outlook, Microsoft Word, Problem Solving, investigator

ERP - 12 Years of Experience - Near 80246

CAREER HIGHLIGHTS * Proven history of driving teams including sponsors, stakeholders, subject matter experts, change agents, designers, and communications experts to design, develop and set forth intricate change management efforts * Expert in the delivery of sound, comprehensive training, and communications solutions * Coach and mentor for company's change agents implementing OCM initiatives for Project Management Office (...

Tags for this Online Resume: A SERIES, IBM, Outsourcing, Communications, Consulting, Project Management, Project Manager, LMS, Change Management, Customer Relationship Management

Investigato - 20 years experience - Near 03062

Investigator with an impressive record of conducting background investigations for the federal government insurance fraud investigations and investigations of waste, fraud and abuse within state government. Skilled at interviewing, collecting and analyzing data, conducting financial reviews, and preparing comprehensive reports for adjudication or prosecution. Extensive experience in garnering cooperation and building relati...

Tags for this Online Resume: Fraud, Insurance, Insurance Claims, Management, Security, Certified Fraud Examiner, Investigator, Massachusetts, New Hampshire, contractor

Federal Government - 7 Years of Experience - Near 20720

to learn FSO roll or adjudications. To further my skills in personnel security.

Tags for this Online Resume: Security

Manager - 20 Years of Experience - Near 19709

Areas of Expertise Business Development Customer Service Relationship Management Market and Product Intelligence Sales and Sales Support Case Development and Support Private Placements Product Development Retirement Planning Strategies Project Management Wealth Management Strategies Executive Compensation Strategies Group Benefits Management Training and Development Affluent and Small Business Marketing Managed department r...

Tags for this Online Resume: Benefits, Insurance, Management, Planning, Annuity, Product Management, Alternative Investments, Benefits Management, Billing, Business Development, manager

Medical Office Manager - 10 Years of Experience - Near 30305

An accomplished Healthcare Practice Manager with a proven track record for building and leading teams that enabled revenue growth. A results oriented accomplished executive with a broad background in business healthcare and human services with operational and administrative expertise. Significant experience in single and multi-service practices urgent care and inpatient facilities. Broad knowledge of healthcare hospice util...

Tags for this Online Resume: Billing, Documentation, Medical, Medical Billing, Medical Records, Medicare, Receivables, 100% Travel, Accounts Payable, Accounts Receivable, healthcare, Trainer, EPIC Trained, Healthcare Management, Healthcare Revenue Cycle, Team Building, physical therapist

Case Management Manager - 9 Years of Experience - Near 99517

Masters in Psychology with addiction emphasis with years of experience in addiction and substance abuse treatment procedures. Positions of a Director Program Manager Contract Case Manager and a Clinician reflects extensive knowledge with adults that have been adjudicated and incarcerated by the State of Alaska. In community reintegration institutional centers and community based residential re-entry settings the experience ...

Tags for this Online Resume: Management, Payroll, Kronos, Kronos (Labor Mgmt Sys), Program Manager, Accounting, Audit, Deposits, Assessments, Behavioral Health, outpatient rehabilitation

Adjudicator

Paralegal - 30 Years of Experience - Near 91201

Tags for this Online Resume: Audit, Documentation, Financial Industry, Internal audit, Internal Auditor, Manufacturing, Coding, Equity, Medical, paralegal

Materials Engineer - 20 Years of Experience - Near 14559

SUMMARY Senior Mechanical Design / Project / Systems Engineer with diverse engineering knowledge, technical skills, project management and project team leadership skills seeking Sr. Mechanical - Project Engineer position. Engineering expertise in defining system requirements, as well as, driving system design, development and manufacturing efforts from initial inception / specification through completion for existing and ne...

Tags for this Online Resume: Engineering, Management, Configuration Management, Configure, Document Management, Integrate, Microsoft Excel, Program Management, Schematics, System Integration, PRODUCT DEVELOPMENT, CAD, CAE, GD&T

Human Resource Labor Relationship Specialist - 20 Years of Experience - Near 08054

Qualifications for Employee Relations/EEO Officer Investigated discrimination claims and directed remedial action for 16 years in preparation for trial. Lead the settlement of disputed claims of discrimination for less than 50% of their initial assessed risk value. While representing management and employees in employment law case in litigation achieved a 93% success rate. I am looking for a non-litigation position where I ...

Tags for this Online Resume: ADA, Ada Programming Language, Benefits, Complaints, Computer Aided Software Engineering, Employee Relations, LESS, Litigation, Management, employee relations, human resources, recruiter