traveling claims analyst Resumes in US: genia

traveling claims analyst Resume

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Name:

genia

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Experience:

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Most Recent Job Title:

traveling claims analyst

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Objective:

To obtain a traveling claims administrating position with a company which I can utilize my skills and knowledge which also provides room for advancement.

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aints/orders.
 Provide basic and FDA standard information to potential customers, licensed physicians as well alternative living patients regarding prescription as well unadvertised natural alternative drug information within the FDA AND UFD guidelines.
 Perform price calculation information as well as shipping methods, dates, containers and quantities to existing and potential customers.
 Maintain inventory stats on back orders, ingredients, and products.
09/2003-05/2005 Schaller Anderson Phoenix, AZ
Customer Service Representative
 Hired as a CICR representative for the Mercy Care Plan where for 11 months received in-bound calls from provider office with inquiries regarding claims payments, prior authorizations, encounter denials, and Coordination of Benefits inquiries.
 Assisted research and adjustment departments with the resubmissions and reconsiderations.
 Advanced to Analyst III position for the Behavioral Health department assisting with claims processing, along with re-pricing facility and professional claims for the State of Arizona, Harrington and any other accounts within the Behavioral Health Department under HIPPA guidelines.
 Primary function to processing research and adjust professional and facility claims for Contact, Behavioral Health, The State of Arizona, and Harrington claims.
03/2003-09/2003 Pinnacle West / APS Phoenix, AZ
Benefits Examiner / Customer Service Representative
 Processed medical and claims for both active and retired APS employees under Cigna, United Health Care, and Pinnacle West Guide Lines.
 Provided customer service to participating and non-participating providers, as well as employees, and hospitals regarding policy provisions, plan guidelines and any other questions under the HIPPA guidelines.
03/2001-08/2001 PC Group Duluth, GA
Customer Service Representative
 Assist agents and customer clients with any questions or quotes regarding auto insurance policies for Texas, California, Georgia, and North Carolina..
 Assist the underwriting department with binding auto policies and any corrections required under the law for existing policies.
 Back up for the premium, finance customer service department.
 Assist the claims, underwriting, premium finance, data entry, and other departments during the conversion period in a call center environment.
01/1991-05/1998 Claim Services Resource Group Dallas, TX
Specialized Benefits Analyst
 Traveled to various assignments for client companies to assist in the reduction strategies of lowering backlogs.
 Specialized in audits, utilization review, adjustments, adjudication of claims, customer service, pre-certifications, and member services..
 Supervised, trained, and was technical lead of 38 employees in the unit.
 Assist investigating fraud and abuse of providers and policyholders.

Education: 1986 - 1988 Robert Morris College Pittsburgh, PA
1985 - 1986 Connelly School of Trade Pittsburgh, PA

Computer Skills: MS Excel MS Word Eldorado RIMMS
Homegrown Software - Many

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