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Online Resumes with "appeals "
Case Manager and UR nurse
AREAS OF EXPERTISE * Insurance Notification Process * Clinical Review Submissions * Inpatient vs. Observation Criteria * Concurrent Denials & Appeals * Staff Mentoring * Electronic Medical Record * Case Management * Cross-cultural Communication * Process Improvement
Tags for this Online Resume: Medical, Nursing, PEDIATRIC, Trauma, Documentation, Management, Neurological, Utilization Management, Cardiovascular, Patient Care
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
Executive Chef - 20 Years of Experience - Near 92101
In Belcreda di Gambolo -ITALY charge of all food service operations * Coordinate the work of the kitchen staff and direct the preparation of meals * Oversee kitchen operations to ensure uniform quality and presentation of meals * Combine culinary skills with knowledge of food science to develop recipes and test new formulas experiment with flavors and eye appeal of prepared foods and test new products and equipment for chai...
Tags for this Online Resume: Chef, Budget Control, Budgeting, Inventory, Scheduling, Consulting, English Language, Food Service
Claims Examiner
Profile Enterprising professional with 15+ years of experience executing medical insurance claims functions. Possesses expertise in insurance, health policy complaints, compliance, and regulations. Employs excellent supervisory skills and builds high-functioning teams through development of targeted training programs. Self-governing and organized, works well in a remote, work-from-home, environment. Core Strengths: Test Pla...
Tags for this Online Resume: Complaints, Documentation, Management, Quality Assurance, Test, Customer Service, customer service skills, Process Improvement, Fraud, Policies and Procedures
Compliance Officer
QUALIFICATIONS SUMMARY Highly motivated healthcare insurance professional with 30+ years of management experience in the healthcare payer arena. Extensive background in healthcare operations, specifically claims, appeals, precertification, healthy lifestyles, case management and call centers. Candidate with proven record of exceeding management goals, implementing performance objectives and process improvements beyond expec...
Tags for this Online Resume: Home Health, Customer Service, Inventory, Managed Care, Management, Computer Aided Software Engineering, Inventory management, PEDIATRIC, Medicare, Pre-certifications
Radiologic Technologist - 20 Years of Experience - Near 07444
PROFILE * Versatile, self-starter with extensive experience in cancer center management with a concentrated focus on patient care. Strengths include: 1) budget management, 2) process optimization, 3) strong negotiation skills and patient navigation through treatment plans focusing on emotional and psychosocial aspects of cancer and patient advocacy. SUMMARY: My position as the Center Manager of the Comprehensive & Prostate ...
Tags for this Online Resume: CT, Front Office, Management, Medical, Nursing, PET, Radiation, Support, Billing
Lawyer - 14 Years of Experience - Near 90045
CIVIL LITIGATION PRACTICE * More than 25 jury trials and 99 bench trials and arbitrations for plaintiffs and defendants * Extensive experience in a broad range of matters involving business civil rights and employment discrimination wrongful foreclosure and landlord-tenant issues personal injury workers' compensation premises and products liability medical and legal malpractice collections construction defects estate planni...
Tags for this Online Resume: Litigation, Operating Systems, Planning, Probate, Transportation, Wordperfect, ABACUS, Apple MacIntosh, Audit, Bankruptcy
Lawyer - 20 Years of Experience - Near 75062
To pursue and accompiish the objectives of a firm/company by utilizing my skili set as an administrator, manager, negotiator, litigator, and marketer. ADMINISTRATORINIANAGER Since my appointment in 2015 by the Mayor and City Council of Irving, Texas I serve as a Director and Finance Committee member of the Dallas County Utility and Reclamation District responsible for managing and maintaining a significant portion of the La...
Tags for this Online Resume: Administrative, Litigation, Personal Injury Case Management, Law Firm Management, General Counsel, Real Estate Title Opinions, Banking Industry, Compensation, Family Law, Insurance
Gaming Manager
will be represented. * (678) 425-1786 * kbradley@ajga.org www.facebook.com/AJGAGolf www.ajga.org/blog @AJGAGolf TOURNAMENT FACT SHEET Quick Facts * 78-player field * 36-hole, stroke play tournament over two days * Four Rolex Junior All-Americans * Nine participants have signed National Letters of Intent * Tournament supported by past AJGA champion and Rolex Junior Player of the Year, Vicky Hurst 2 Tournament Storylines * In...
Ideal Companies: 1954
Tags for this Online Resume: Facebook, Futures, Ile, Microsoft OLE, Network Operating System, Professional Communication, TEE
Excellent insurance sales experience with the constant balance of underwriting (company) and service (client).
My career objective is to obtain financial position within either the Insurance or the Banking industries offering a full-time, direct employee position. I welcome responsibly and have experience managing each market to operate at full staff capacity; a proven record of achieve or exceed business goals.
Ideal Companies: USAA, Amica Insurance, Allstate Insurance, Wells Fargo, UnitedHealth Group, BB&T, Bank o America, & ect...
Tags for this Online Resume: analyze risk, profitability, retention, counseling borrowers, advanced verbal and written communication skills, relationship-building skills, marketing, integrity, manager experience, proven sales experence
Administrative Assistant - 20 Years of Experience - Near 20639
Manage all Attorney Trust Accounts and work closely with Assistant Bar Counsel and Investigators * Maintenance and creation of existing/new docket cases Draft pleadings discovery motions lines etc. to Court of Appeals and all other Circuit Courts. Legal research drafting/editing letters to clients and the courts.
Tags for this Online Resume: Administrative Assistant, Billing, Autocad, Autodesk AutoCAD, Benefits, Human Resources, Management, Property Management, Security, Vendor Invoices
Legal Support Worker - 19 Years of Experience - Near 75074
Summary Seasoned Revenue Officer National Quality Reviewer and Manager for Small Business/Self Employed (SB/SE) Division with the Internal Revenue Service. Skills: Customer Service, Accounting, Communication, Writing, Partnering, Tax Law with emphasis on Bankruptcy Law (Chapter, 7,11, 13 and 15), Notice of Federal Tax Lien Law (Certificate of Non Attachments, Subordination's, Subrogations and Discharges). Extensive experien...
Tags for this Online Resume: Accounting, Analytical Thinker, Bankruptcy, Communication Skills, Customer Service, Federal Tax, Management, People Management, Quality, Quality Assurance
