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Online Resumes with "appeals"



Manager/Director Disability Appeals and Claims - 18 Years of Experience - Near 04106

Additional work as a Senior Team Lead of Fraud Detection currently for WEX, a major fuel card distributor.

Tags for this Online Resume: Account Management, Litigation, Management, Settlements, Drafting, Fraud, Fraud Detection, Predict, Predict (Data Dictionary), Quality Assurance, insurance, customer service, group benefits associate, investigator, employee benefits

Featured Profile

Sales Representative - 8 Years of Experience - Near 14420

I am a dynamic record winning salesperson. I specialize in turning cold calls into sales. I manage completing new accounts while continuing to work on negotiating new business on a daily basis. I am self-motivated with a high energy level. I enjoy working as part of a sales team. I have no problem putting my experience to use in whatever way can help advance a company.

Ideal Companies: No preference. I have no interest in the insurance or financial services industries.

Tags for this Online Resume: Rochester, NY, B2B Sales, Published Author, Contract Negotiating, Winning Salesperson, Cold Calling, Building Business Relationships, Customer Solutions, Communication Skills, Customer Relationship Management

Claims Examiner - 20 Years of Experience - Near 33594

Tags for this Online Resume: Distribution, Quality, Quality Assurance, Commissions, Microsoft Internet Explorer, Benefits, Compliance, Research, Complaints, Team Lead

Registered Nurse

Tags for this Online Resume: Medical, Medical Records, Computer Aided Software Engineering, Management, Assessments, Emergency Room, ER, Trauma, Documentation, Nursing

Quality Coordinator - 20 Years of Experience - Near 85249

Summary of Qualifications * 90 credit hours, an undergraduate degree in International Business * 20+ years experience in the Health Insurance Industry with recent experience in Human Resources. * Demonstrated ability to build rapport and resolve complex issues among multiple entities with conflicting interests. * Excellent skills in communication and collaboration. * Highly inquisitive, a team leader.

Tags for this Online Resume: Audit, Workers Compensation, Compensation, Complaints, Data Entry, Lotus, Lotus Notes, PeopleSoft, Management, Benefits

Case Manager - 20 Years of Experience - Near 19406

Tags for this Online Resume: Computer Aided Software Engineering, Critical Care, Management, Medical, Pulmonary, Surgical, Therapy, Acute Care, Nursing, Cms

Case Manager - 21 Years of Experience - Near 19406

Baccalaureate-prepared Registered Nurse with extensive experience in case management and utilization review. Combining acute care experience, interpersonal communication skills and documentation expertise to optimize the care provided to patients. Skills/Areas of Expertise Case Management * Utilization Review * ICD-10 * InterQual Criteria * CMS Regulations * Electronic Medical Records

Tags for this Online Resume: Management, Computer Aided Software Engineering, Critical Care, Medical, Pulmonary, Surgical, Therapy, Acute Care, Nursing, Medical Records

Registered Nurse

Tags for this Online Resume: ENT, Transcription, Budgetary, Cms, Management, Patient Care, Cardiovascular, CHF, COPD, Emergency Room

Contract Administrator - 0 Years of Experience

Handled development of a large unimproved commercial parcel located at the northwest corner of Meadowbrook Road and Grand River Avenue in the City of Novi. Coordinated construction of a campus style shopping center in the Grand River frontage and sold the back end to Soccer Zone and the east side to three out lot buyers. * Drafted acquisition documents, permit applications, zoning appeals, easements for utilities, ingress ...

Tags for this Online Resume: Assessments, Sales, Sales Tax, Security, Acquisitions, Drafting, Purchase Agreements, Fabricators, Accounts Receivable, Applications

Featured Profile

10 years Legal Analyst - Contract Negotiation and Compliance

A position which allows me develop the employees within my department to be open-minded to new ideas and brainstorming while independent thinkers; have the opportunity to be part of a team that is building a stronger tomorrow while utilizing my skill for logic and analyzing issues with a company that rewards strong work ethic and loyalty.

Ideal Companies: IBM, General Food, Rocky Mountain HMO

Tags for this Online Resume: Legal Analyst, Client Service, Project Management, Compliance, Advisor, Leader, Resource, Strong advocate, Project Manager, Real Estate

Case Management Manager - 0 Years of Experience

I am highly analytical healthcare case management professional who combines more than 15 years of work in the medical insurance field with proficiency in administrative management, leadership and positive regulatory outcomes. I am an adaptable healthcare administrator accustomed to the integration of new healthcare delivery system and restructuring of work in an increasingly complex regulatory environment. I excel as a tra...

Tags for this Online Resume: Computer Operator, Management, Staffing, Staffing & Recruitment, Health Insurance Portability And Accountability Act, Insurance, Nursing, Patient Care, Pediatrics, Benefits

Quality Assurance Director

Tags for this Online Resume: ENT, Transcription, Budgetary, Cms, Management, Patient Care, Cardiovascular, CHF, COPD, Emergency Room