Contracting Credentialing Coordinator Analyst Resumes in US-Ohio-Northwest: Martice

Contracting Credentialing Coordinator Analyst Resume

Contact Candidate

Name:

Martice

Location:

US-Ohio-Northwest

Experience:

Willing to Relocate:

Willing to Travel:

Most Recent Job Title:

Contracting Credentialing Coordinator Analyst

Personal Website:

Objective:

To obtain a position with a growing and stable company that will allow me to utilize and enhance my excellent business, and professional customer service skills.

Resume Text:

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EDUCATION:

Continuing Education Adult Liberal Studies, University of Toledo

1984-1988 Graduate-Macomber Whitney Vocational Tech. H.S.

EMPLOYMENT:

2006-Current Managed Care Contracting Credentialing Coordinator Analyst, HCR Manor Care- Toledo, Ohio

Assist the Managed Care Department member assigned to Home Health, Hospice and Infusion contracting for Heartland Home Health Care and Hospice as well as the Director with administrative tasks including but not limited to processing mail, T & Es, photocopying, faxing, typing, phone calls, and scheduling meetings. Coordinate and prepare all credentialing information for release to managed care plans. Assist with research of managed care plan information and financial calculations, contract implementation tasks, facilitate the paperwork of initial contracts through completion of contracts, maintain a contract matrix and contract summaries. I assist Manager and Director in areas of negotiations, pricing, and financial analysis for the managed care contracts. Provides quarterly progress reports on specific contract performance- quantitatively and financially, maintain confidentiality of necessary information.

2001-2006 A/R Billing & Collection Specialist, HCR Manor Care- Toledo, Ohio

Responsible for the investigating, auditing, and collection on home care medical claims, following up with insurance companies, performing electronic and manual home care billing to various commercial insurance companies, as well as out of state Medicaid companies and Medicare providers online.

1998-2001 Sr. Claims/ CSR, Medical Mutual of Ohio- Toledo, Ohio

Perform all administrative customer satisfaction services including phone, written and/ or correspondence and adjustments, as well as account auditing. Investigate, analyze and facilitate payment of care claims. Process claims in accordance with contract plans, quoted benefits from such plans as Medicare, Medicaid, HMO, and all Super Med contract plans.

1996-1998 Patient Account Rep/ Admitting Registration Clerk, St. Vincent Medical Center- Toledo, Ohio

Daily responsibilities included registering patients for services such as inpatient and outpatient hospital services, updating and revising patient’s demographic and insurance information, data entry, pulling and filing explanation of benefit notices and remittance advices for billing purposes. Billed commercial insurances companies for primary and secondary payment of care claims.

Related skills:
Type 30-40 wpm, numerous Microsoft applications, Windows NT, 95-98, Excel, WordPerfect applications, two years experience supervising various home daycare providers for the Salvation Army Child Care Food Program.

REFERENCES FURNISHED UPON REQUEST

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