CV, Curriculum Vitae and Online Resumes Search

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Online Resumes with "medical records reviews "

Claims Investigator

Summary Driven employee focused on operating responsibility at the highest level of ethics. Doing the right thing for an organization and operating within set budget and guidelines. My field of expertise is diverse. I have held several positions within an office environment which included database searches, reporting with the usage of all available data, liability field and office claims handling including but not limited t...

Tags for this Online Resume: Arbitration, Billing, Fraud, Insurance, Medical, Budgeting, Coaching, Communication Skills, Database, Legacy

Quality Coordinator

To apply for a position in appeals, medical record review, or concurrent review

Tags for this Online Resume: Internal Auditor, Medical, Medical Records, Medicare, Medical appeals, utilization review, concurrent review

Registered Nurse - 22 Years of Experience - Near 65202

Tags for this Online Resume: Medicare, Nursing, Insurance, Managed Care, Assessments, HEDIS, Health Coach, Disease Management, Preauthorization, Utilization Review, Quality Improvement, Quality Review, Medical Record Review, URAC, Case Management, Drug Adherence

Registered Nurse - 20 Years of Experience - Near 27343

CAREER HIGHLIGHTS * Recognized for consistently mastering procedures, the ability to take on new roles within each practice, and for exceeding demanding production objectives. Interacted successfully and built rapport with physicians with strong personalities and diverse leadership styles. * Demonstrated outstanding skills which resulted in a request to provide comprehensive orientation trainings to newly hired staff. * Gai...

Tags for this Online Resume: Medical, Medical Records, Nursing, Triage, Management, Referrals, Endoscopy, Assessments, Computer Aided Software Engineering, Documentation

Registered Nurse - 20 Years of Experience - Near 65262

SUMMARY: RN with 20 plus years of experience in case, disease and utilization management, medical record review, claims processing, quality, appeals and grievances. Successful contract and care management platform and program implementations. Vast knowledge and experience of complex disease management. Able to manage large member caseloads and prioritize large volume of member activities. Great communicator when presenting ...

Tags for this Online Resume: Business Requirements, Data Analysis, Product Design, Services, Assessments, Billing, Computer Aided Software Engineering, Management, Medical, Medical Records, registered nurse, healthcare, care, rn, nurse, care manager, case manager, quality, utilization management, management, appeals, claims

Licensed Nurse - 20 Years of Experience - Near 32825

AREAS OF EXPERTISE Worker's Compensation Claims Licensed Practical Nurse Time Management Claims Analyst Case Management Triage Assessment Third-Party Interaction & Collaboration Medical Record Review Diagnostic & Treatment Plans State & Federal Regulations & Compliance Process Improvement Team Engagement Detail-Oriented Leadership Clinical Information Assessment Return To Work Planning Risk Mitigation Medical Cost Containme...

Tags for this Online Resume: Leadership, LPN, Nursing, Management, Compliance, Account Management, Clinical Management, Computer Aided Software Engineering, Documentation, Planning

Quality Assurance Director - 20 Years of Experience - Near 60440

Summary of Experience An exceptional operations professional with more than 20 years in a healthcare setting. Established and implemented regulatory policies and procedures, quality services and revenue management metrics. Responsible for all provider claims reimbursements, satisfaction and provider contract negotiation functions and oversight. Experienced in payment software, quality audits and technical problems associate...

Tags for this Online Resume: Services, Financials, Management, Behavioral Health, Business Operations, Project Management, Project Manager, director operations, Provider Network, Claims Operation, Healthcare

Registered Nurse

Manage time well and self-motivated. SUMMARY SKILLS EXPERIENCE 01/2015 to 06/2017 02/2006 to 01/2015 08/2004 to 01/2005 MCKNIGHT FL 33805 H: 863-680-2091 C: 863-604-6096 weeezie@aol.com Results-oriented Quick learner Client-focused Proficiency in Quality Assurance Proficiency in Patient Assessment Proficiency in Medical Record Review and Assessment Nurse First Response/Utilization Review Conduent - Lakeland, FL . Assessed p...

Ideal Companies: Cornerstone Hospice, Chapters Healthcare, Lakeland Regional Health

Tags for this Online Resume: Computer Aided Software Engineering, Documentation, Legal, Quality Assurance, Referrals, Test, Transportation, Triage, Wound Care

Registered Nurse - 20 Years of Experience - Near 07601

RESUME Summary: Professional Nurse with more than 15 years of experience in a leadership position in a Magnet hospital and other healthcare organizations. Possesses excellent clinical and administrative skills, i.e. organization, recruitment & retention, problem-solving with corrective action planning, staff development, coaching/mentoring, performance evaluation, utilization review, medical records review, budget planning,...

Tags for this Online Resume: registered nurse, healthcare, Leadership, Payroll, Performance Evaluations, Scheduling, Administrative Skills, Budgeting, Coaching, Health Care Industry

Registered Nurse - 20 Years of Experience

Professional Summary: Donna Lowe, RN CCM brings 20+ years of clinical experience with 11 years in direct Case Management in an acute care setting. She has 10 years experience with Discharge Planning and Complex Care Management with a successful record of decreasing the overall acute care length of stay. Donna has substantial experience in coordination of resources across the hospital from the ICU, ER, Neuro, Cardiac, Ortho,...

Tags for this Online Resume: Case Manager, Certified RN Case Manager, Detailed Medical Record Review, registered nurse, CCM, Workers Compensation, Local travel, Legal, Medicare, Patient Care

Paralegal - 20 Years of Experience - Near 70065

Professional Summary: Accomplished litigation paralegal * Experienced in preparing numerous cases for trial, exhibits, bench books and attending multimillion dollar trials * Experienced in medical records review, summarizing & chronology * Able to manage and organize voluminous files through settlement or trial * Litigation experience includes drafting of petitions, motions, etc., and propounding and answering discovery * E...

Tags for this Online Resume: Litigation, Defense, Insurance, Insurance Defense, Drafting, Scheduling, Management, Medical, Adobe, Applications