|Desired Industry: Healthcare
|Desired Job Location: Galveston, Texas
||Date Posted: 8/11/2015
|Type of Position: Full-Time Permanent
||Availability Date: 08/31/2015
|Desired Wage: 70,000
||U.S. Work Authorization: Yes
|Job Level: Management (Manager, Director)
||Willing to Travel: Yes, Less Than 25%
|Highest Degree Attained: Masters
||Willing to Relocate: No
Strong people and time management skills with a proven ability to prioritize, organize, delegate, coordinate activities and tasks to be able to achieve goals, meet deadlines, maintain budgets and establish office procedures. A background in staffing and interviewing potential employees. Take charge professional with can do attitude, who strives to be a strong team builder by continually learning, motivating and training others to achieve company goals.
Accomplished leader in implementing business plans to enhance financial performance through increased revenue, cost controls, streamlined procedures and the efficient use of resources.
Proven ability to prioritize and delegate tasks, organize and coordinate activities, manage time, set and achieve goals, meet deadlines, maintain budgets and establish office procedures.
High energy leader and excellent communicator, with agents to prescreen new business applicants, discuss offers of coverage and to obtain outstanding underwriting requirements, ensuring that teams are synchronized in their knowledge. Focus expectations, projections and ideas to accomplish a goal.
Proactive Lead Medical Underwriter driven toward continuous improvement in the underwriting process.
Performed new business and renewal underwriting functions, including risk analysis within tight turnaround time targets. Which also include obtaining underwriting requirement such as personal history interview and prescription history.
Reviewed and discussed Medicare Supplement applications for accuracy, completeness and determined, if additional information was necessary to be fulfilled underwriting requirements such as state regulated forms.
Evaluated and classified health insurance applications, reissues, policy changes and reinstatements. Which, involved interpretation of information from various sources which was analyzed in order to properly approve, decline or request additional information for consideration for insurance coverage.
Multitask in fast paced environments, dedicated to maintaining a reputation built on quality, service and uncompromising ethics.
Monitored budget and identified internal controls to ensure compliance with budgets.
Managed two facilities for consolidating employee hours, equipment and supplies. Resulted in a cost savings of $50,000 in the first six month. Recognized as a driver of change, utilizing strong analytical skills to identify areas of strength, weakness, implement company policies, standards, and changes in procedures that optimize productivity.
Trained new employees on guidelines for processing Medicare Open Enrollment and Guarantee Issue laws and regulations that are regulated in the different states.
Assessed medical risks to determine insurance would be offered for Medicare Supplement coverage.
Expertise in training, coaching, and building strong teams, while creating a culture that values individual contributions and promotes confidence, excitement and enthusiasm.
Managed Surgical Center budget reconciliation and provided reporting on a monthly, quarterly and year end basis.
Responsibilities: clerical supervision and training, scheduled appointment, answered telephone queries, maintained computerized patient account data.
Served as a liaison between surgery center, administration, medical staff, and patients concerning the resolution of health care complaints. Along with pharmacies, hospitals, ordered medication refills, scheduled surgeries, scheduled testings, physical therapy and lab work for clients.
Arranged for doctors to be authorized providers for Medicare, Medicaid, different insurance companies and coordinated with doctors to get into I.P.A. Groups.
Managed billing, coding functions for insurance reimbursement and Medicare compliance.
Billed patients for doctors, filed insurance claims for Workers Compensation, Medicaid, Medicare and Commercial Insurance. Working knowledge of HMOs, PPOs and insurance coding.
Worked with insurance companies to verify insurance, get pre-approvals for hospitalization stay, surgeries and resolve patient billing problems
Supervised medical office personnel, including scheduling work assignments, monitoring performance quality of work, and assuring compliance with company policies and procedures.
Managed the classroom environment and promoting student learning.
Master of Education Grand canyon University, Phoenix, AZ
Bachelor of Business Administration American InterContinental University, Hoffman Estates, IL
D.A.R.-Daughters of the American Revolution
Collections Managerial Accounting
AR Payment Posting Organizational Controls
Pay Bills Financial Management
AP Balance Sheets
Double-entry Bookkeeping System Financial Reports
Excel,Access,Microsoft Word,Windows XP, Windows 8 and Internet
Available upon request.
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