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Online Resumes with "claims adjudication"
System support management for Operations with focus on workflow, imaging, process management
To increase customer satisfaction through innovative and strategic solutions that add value to their operations.
Ideal Companies: RedHat
Tags for this Online Resume: SDLC, Workflow, Process Design, Lean, Agile
Claims Adjuster
Tags for this Online Resume: claims adjudication, provider enrollment, employee training, customer service
Experienced Community-Based Registered Pharmacist with Ohio Immunization Certification
I am seeking a position that will allow me to utilize my education and extensive experience as a pharmacist.
Ideal Companies: Express Scripts, Aetna, State of Ohio, Cover My Meds, Bioscript, Caresource, AIDS Resource Center, Sears Holdings, CVS, Kmart, Helios, Costco, PMSI
Tags for this Online Resume: pharmacist, immunization, patient education, medication therapy management, MTM, inventory control, compounding, Columbus, Ohio, Immunizing pharmacist, staff, retail, registered pharmacist, drug utililization review, customer service, communication, dispensing, prescriptions, OTC, self-care, diabetes, asthma, lipid, smoking cessation, herbals, vitamins, health coaching, monitoring, compliance, adherence, nutrition, skin care, direct, drug interactions, interpret, community pharmacy, ambulatory care, drugs, medications, advise, drug selection, counseling, pharmaceutical care, disease states, improve outcomes, hypertension, pharmacist-patient relationship, chronic disease, patient assessment, drug information, non-prescription, public health, drug delivery, consulting, preventative medicine, mail order, managed care, pharmacoeconomics
oerations supervisor 25 years experience
My goal is to be employed in a position where I can utilize my 20 plus years in the healthcare industry. I have been employed in the industry in many capacities as a Billing Manager, Insurance Specialist, Claims Adjudicator, Collections and Cash Application, Customer and Provider Relations in physician’s offices, hospitals and insurance companies. Software: Medical Manager, Misys, Homesys, Pragmatics , EZ Claim and various...
Tags for this Online Resume: billing and colloections, Payment processor, claims adjudication, ar specialist, credentialing, revenue tracking
Chief Information Officer - 25 Years of Experience - Governance, BI, Consulting Principal, BI, Healthcare, Engagement Manager, Project and Program Management
Desire for a position in a fast pace company where I can have an impact as an Executive or Delivery Consultant. I wish to leverage my background crosses multiple industries and ranging in size from VC start up to Fortune 10. I love to work with peers, managers and partners to develop solutions, technology, process nd people.
Ideal Companies: Ernst & Young, Dell Enterprise, Deloitte, GE Healthcare, Xerox, Fidelity
Tags for this Online Resume: CIO, RCM, Consulting, BI and Analytics, Application Development, GE Healthcare, Healthcare Technology, Business Intelligence, Practice Management Systems (PMS), EMRs, Enterprise Governance, Data Governance, CMMi, SAS-70, SSAE-19, ASP, Call Center, Accountable Care Organization, Executive Presentations, Software Development, Business Process Outsourcing, ITO, Outsourcing, Strategy, Process Engineering, Technology Management, Project Management, Program Management, Data Quality, Data Security, BI Management, Systems Integration, Healthcare Analytics, Claims Adjudication, Insurance Industry, Property and Casaulty, Life and Health, Healthcare Systems, CTI, Service Management, Engagement Management, Budget > $100M, Technology Standards
Claims Investigator
Career Summary MORE THAN 30 YEARS AT ASSURANT HEALTH/FORTIS/TIME INSURANCE COMPANY. EMPLOYMENT ENDED DUE TO COMPANY CLOSING. POSITIONS HELD: CODING REVIEW ASSOCIATE/PHYSICIAN AUDIT EXAMINER, HEALTH CORRESPONDENT/APPEAL RESOLUTION SPECIALIST, MEMBER SERVICE REPRESENTATIVE, PROJECT COORDINATOR, CORPORATE COMMUNICATIONS ASSISTANT, BENEFIT ASSISTANT, DATA ENTRY CLERK, AND CLOSE CLAIMS CLERK. Accomplishments and Career Highlight...
Tags for this Online Resume: Benefit Specialist, Appeals Specialist, Quality Assurance, Claims Representative, Project Coordinator, Customer Resolution Specialist, Telecommute, Customer Service, Clinical/Code Review, Claim Investigations, Data Support Specialist, Adjustment Specialist
Medical or Health Services Manager - 20 Years of Experience - Near 22655
723 Duties and responsibilities: * Prescription intake, data entry, online claim adjudication, filling, verification, dispensing, and filing patient pharmacological, toxicological, and nutritional counseling inventory control pharmacovigilance and medication therapy management (including coordinating patient care with prescribers, chiropractors, physical therapists, etc.). The Wellness Pharmacy - 6883 *
Tags for this Online Resume: Cardiopulmonary resuscitation (CPR), Medical, Medical Terminology, Pharmacology, Control Data, Data Mining, Health Insurance Portability And Accountability Act, Mining
General
Tags for this Online Resume: Audit, Management, Procurement, Prime, Pricing, Project Management, Rehabilitation, Acquisitions, Administrative Assistant, Adobe, Contract Management, Subcontract Administration, Dispute Resolution, War Zone Experience, Claims Adjudication, Iraq Oil Field Experience
Claims Examiner - 20 Years of Experience - Near 78660
KEY QUALIFICATIONS * Highly-skilled claims manager strong oral and written communication skills * Proven track record of integrating process improvements to increase business profitability * Extensive understanding of Oklahoma/Texas WC statutes, case laws and claims adjudication * Excels in leadership, training and mentoring
Tags for this Online Resume: Compensation, Automation, Claim Processing, Litigation, Management, Recruiting, Training, Medicare, Communication Skills, Computer Aided Software Engineering
Materials Manager
SUMMARY Healthcare professional with extensive experience in training, management, reconciliation, audit, Medicaid and Medicare regulations. Experienced with federal regulations and compliance. Experienced with analysis and preparing reports for management. Medical claims Adjudication and Network Management.
Tags for this Online Resume: Management, Policies and Procedures, Audit, Business Analysis, Compliance, Medicare, Cms, Complaints, Business Analyst, Integrate
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
Tester - 14 Years of Experience - Near 92121
Experience Summary Overall 15 years of Total Experience in the IT Industry, and 5 year of Experience in Syntel * Very strong Domain knowledge in Health Care * Hands on knowledge in FACETS Application (Member, Plan/Product, Provider, Eligibility & UM) * Working experience on Agile testing methodology. Acting as Scrum Master. Organize Sprint planning meeting, Daily Scrum Meeting, Creating Sprint report, Create task to the tea...
Tags for this Online Resume: Consulting, Quality Assurance, Structured Query Language, Test, Cognos, Health Care Industry, IBM, Script, System Testing, Test Cases
