CV, Curriculum Vitae and Online Resumes Search

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Online Resumes with "claim operations"

Personal Lines Claims Industry Manager/Consultant - 20+ Years Experience - Open to Relocation

I have extensive experience in the Property & Casualty Insurance Claims industry and am seeking to further advance my career through acquisition of a senior or executive level manager/consultant role at a small to mid-level insurer that is growing and needs to transform their current claims operation into one that is state of the art in all aspects utilizing my innovative skills and experience.

Tags for this Online Resume: Six Sigma, Transformation, Innovation, Re-Engineering, Future State, Leadership

P & C Claims Operations - 20 Years of Experience - Near 07738

Use skills acquired during my 30+ years of work in the insurance industry as a Claims Handled, Claim Management Consultant and Operations Officer to help organizations improve work flow efficiency, operational effectiveness and excees financial objectives.

Tags for this Online Resume: Claim Operations, Claim Management, Claim Consulting

Management

Managing Claims Operation, adjudication and payment functions of physical health claim submissions. This includes interfacing with clients on issues such as claims processing and adjudication, data collection/retention, regulatory compliance, financial analysis, and other duties as assigned by the Director.

Claims Manager-20 years Experience-Motivated to Relocate

Dynamic Manager who excels at organization and efficiency looking for new opportunities in Claims or Operations Management. Able to multi-task but also focus on prioritization. Excellent at developing relations with clients. Extremely customer focused. Believes that quality must set you apart from the competition. Ability to spot talented individuals and bring them into the organization. Work ethic that is second to ...

Tags for this Online Resume: management, responsive, budgeting, saleforce, microsoft, california, florida, operations

Claims Examiner - 20 Years of Experience - Near 02720

Claire is a commercial Property/Casualty insurance claims executive with a proven track record of building profitable claim services businesses while delivering exceptional client value. The foundation of her entrepreneurial success is her passion for, and dedication to her clients; broad industry network; large loss claim management expertise; and varied claim operations management and business development experience.

Tags for this Online Resume: claims, account management, casualty, liability, claims management, business development, claim operation, worker's compensation

Market Conduct, Compliance, Medical Claims, Appeals - 16 Years of Experience - Near 53154

CAREER SUMMARY Dedicated health insurance professional with more than 16 years of experience in Claims Operations, Market Conduct and Regulatory Compliance along with Underwriting. Advanced skills in analyzing data and implementing improvements that enhance operations. A proven innovator in obtaining results with an acute attention to detail. Skills and abilities include: Project leadership, Medical terminology, Regulation ...

Tags for this Online Resume: Project Leader, Medical Records, Risk Assessment, Underwriter, Appeals, Grievances, Critical Thinking, Milwaukee, Microsoft Office, Insurance, Medical

Claims Examiner - 18 Years of Experience - Near 48334

Qualifications: My strengths include strong leadership skills, communicating effectively with the public and employees. My daily responsibilities also include claim operations and managing claims in the State of Michigan and our Regional market as well as making use of the knowledge of potential fraudulent activities.

Tags for this Online Resume: Guardian, Guardian (Comm Net Sw), Insurance, Insurance Claims, Billing, Audit, Budget Preparation, Budgeting, Call Center, Filing

Executive Vice President - 15 Years of Experience - Near 92708

Energetically outperforming healthcare executive with various roles as VP/ CFO/ COO who helps started two MAPD SNP Health Plans, a MSO, 2 IPA's, a Multi-Specialty Medical Facility successfully from scratch. Ability to roll up sleeve and dive in any challenge incurred in healthcare management and increase shareholder ROI.

Tags for this Online Resume: Management, Accounting, Consulting, Medicare, Infrastructure, Billing, CMS, EDI, Electronic Data Interchange, Insurance, Medicaid, CMS, Program Management, Project Management, Operations, HEDIS, Risk Adjustment, Revenue Cycle, Provider Contracting, Network Expansion, Healthcare Software Development, Claim Operations, Finance

Team Leader

Areas of Expertise: * IT & operational transformation * Application development & production support * Data management & business intelligence * PMO - Portfolio, program & project management * Enterprise infrastructure strategy & management * Financial management of large IT budgets * Software engineering, application development methodology & solution architecture, programming languages * Supplier & vendor management - ons...

Tags for this Online Resume: Application Development, Development Methodology, Budgeting, Financial, Financial Services, Services, Automation, Information Technology, Insurance, Management

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