JOHN RAZO 2015 RESUME
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John Razo has over 25 years of experience in the healthcare industry with expertise in claims processing, medical billing and coding, auditing, and project management. He has held roles as a claims adjuster, supervisor, project coordinator, and analyst. His most recent role was as a claims adjuster at Health Net from 2003 to 2015 where he determined policyholders' benefits and completed special projects.
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Stanley W. Robinson has over 20 years of experience in healthcare claims management and quality assurance. He has expertise in claims processing, provider reimbursement, and system implementations. Robinson has held several leadership roles where he managed claims operations, trained staff, and ensured claims were processed according to contracts, policies and regulatory requirements. He is proficient in various claims processing systems and tools.RLSkowronski, 06262015
RLSkowronski, 06262015Robert Skowronski
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Robert Skowronski has over 20 years of experience in health insurance and managed care. He is currently the Deputy Commissioner of Vermont Health Connect, where he was recruited to fix development and implementation issues. Prior to this role, he held various project management and process improvement positions at UnitedHealthcare, focusing on initiatives to improve clinical quality, reduce costs, and increase efficiency. He has a background in data analytics, process redesign, and problem solving to meet business goals.DebbieLResume4
DebbieLResume4Debbie Loftis
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This resume summarizes Deborah Loftis' experience in the insurance industry spanning over 28 years, including various leadership positions such as lead, supervisor, senior account manager, and project manager. She has expertise in commercial lines of business, workers' compensation, policy administration, and project management. Her experience also includes proficiency with Microsoft applications and expertise in insurance rating, underwriting, and claims.Monica Wrights Resume
Monica Wrights Resumemonica wright
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Monica Wright has over 20 years of experience in insurance billing, collections, customer service, and administration. She currently works as a Billing Trainer for Emory Healthcare, where her responsibilities include training staff, processing insurance claims, working with patients on billing and payments, and managing billing operations. Previously, she held roles in medical billing and worked as a Referral Coordinator at Emory Healthcare. She aims to provide superior customer service and uses various software programs to perform her duties.Rashid Peterson resume
Rashid Peterson resumerashid peterson
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Rashid Peterson is seeking a position that requires efficiency and strong customer service skills. He has over 10 years of experience as an Eligibility Specialist and Caseworker for government assistance programs. His experience includes determining eligibility, processing applications, conducting interviews, and ensuring compliance. He is proficient in all Microsoft Office programs and systems used for benefits programs like Medicaid. He is motivated, adaptable, and has a strong track record of accuracy in his work.Steve Sanders' Resume
Steve Sanders' ResumeSTEVE SANDERS
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My name is Steve Sanders and I am an Operational Administrative Manager, with strong experience in Healthcare Management, Healthcare Benefits Management and Healthcare Business Management. I also have a great deal of experience with, and very much enjoy, face to face customer / patient services, retail sales, compliance and software oversight and training including HIPAA, SOX, the EEOC, the FDA the SEC and OSHA. My expertise in healthcare insurance and a clear understanding of various state and federal compliance agencies made me a viable and useful adjunct within the Human Resource Department. Over the past 30 years of employment Ive delivered improvements to my employer's financial stability and have provided day to day patient / customer service that have contributed to my employers stability and growth. I also have a great deal of experience in Food Product Development, Manufacturing, Marketing, Sales and Distribution. I have strong experience in Individual / Team Project Leadership, contract implementation, oversight and negotiation.Merrell Fleming Functional Resume 0815
Merrell Fleming Functional Resume 0815Merrell Fleming
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Merrell Fleming has over 31 years of experience in various industries including banking, insurance, office furniture, product manufacturing, and accounting. She has a proven track record of streamlining processes, improving productivity and customer satisfaction. Fleming is skilled in areas such as project management, data analysis, problem solving, and software proficiency.Resume update 2016
Resume update 2016Crystal Gomez
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Crystal Ann Gomez has over 10 years of experience in claims processing and auditing for various healthcare organizations in Southern California. She is currently a Claims Internal Auditor at Inland Empire Health Plan, where her responsibilities include recovering overpayments, trending errors, and responding to compliance issues. Previously she has held roles as a Claims Auditor, Claims Examiner, and Claims Processor/Analyst. She has extensive knowledge of healthcare claims databases, fee schedules, and regulations. She is pursuing an Associate's degree in Small Business Entrepreneur from Chaffey College.Calvin beecher resume_implementations
Calvin beecher resume_implementationsCalvin Beecher MBA, MS
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Calvin Beecher is an experienced Implementation Manager with over 20 years of experience in account management, project management, and client services. He has a background in healthcare administration and nursing. Currently he is a Senior Consultant at CVS Caremark where he manages implementations and operations for external Accountable Care Organizations. Previously he held various roles with increasing responsibility at CVS Caremark, United Healthcare, and the US Army.Francine Martin Resume June 2016
Francine Martin Resume June 2016Francine Martin
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This document provides a summary and contact information for Francine Martin, who has over 12 years of experience in the healthcare insurance industry seeking a position in account management, client relations, or case management. She has expertise in claims payment, adjudication, and auditing while maintaining professionalism, productivity, and efficiency. Her experience includes positions at Magellan Health Services, UnitedHealth Group, Chase Staffing/Assurant Group, and Empire BlueCross BlueShield. She is proficient in Microsoft Office, various claims processing systems, and communication platforms.CherriWilliamsResume5_Insurance
CherriWilliamsResume5_InsuranceCherri Williams
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Cherri Williams is seeking a leadership position in the insurance/financial services industry. She has over 25 years of experience in claims management, including opening a new claims office and managing teams that adjusted property, casualty, and injury claims. She has strong project management, change management, and people leadership skills.Andre_Wallace_Analysts_ Resume
Andre_Wallace_Analysts_ ResumeAndre Wallace
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Andre P. Wallace has over 15 years of experience in the financial services industry, focusing on mortgage loan compliance, quality assurance, risk management, and loan modifications. He has held roles as a Compliance Analyst, Tax Preparer, MHA Case Specialist, Risk & Compliance QC Analyst, Loss Prevention Specialist, and Underwriter. Wallace has extensive knowledge of mortgage regulations and guidelines including HMDA, RESPA, TILA, GLBA, BSA, AML, and HAMP. He holds certifications in numerous financial compliance areas and has strong analytical, auditing, and customer service skills.resume2014
resume2014Denise Kelly
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Denise Kelly is seeking a position that utilizes her 15 years of experience in collections, loss mitigation, foreclosure, quality control, negotiating, and bankruptcy. She has strong communication, research, problem solving, and negotiation skills. Her previous roles include positions at JP Morgan Chase as a Bankruptcy Specialist and Foreclosure Specialist, and at Ally Financial as a Loss Mitigation Specialist.HadlockEllisCleanCritDoc(1)
HadlockEllisCleanCritDoc(1)Ellis Hadlock
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Ellis Hadlock has over 15 years of experience in claims processing and team leadership in the health insurance industry. He has a proven track record of consistently meeting or exceeding production standards for quantity, accuracy, and timeliness. He is skilled in various types of claims processing including outpatient, Medicare, coordination of benefits, dental, surgery center, and home health claims. Currently he works as a Claims Service Analyst for Regence Blue Cross Blue Shield where he analyzes and timely processes high volumes of professional and hospital claims using medical terminology and coding systems.Natalie Davis - Resume v4
Natalie Davis - Resume v4Natalie Davis
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Natalie Davis has over 10 years of experience in customer service and healthcare billing. She has an Associate's Degree in Humanities and Social Sciences. Her most recent role was as a Medical Claims Processor and Customer Service Representative where she was responsible for receiving, analyzing, and adjudicating medical claims using various coding systems. Prior to that, she worked as a Customer Service Representative for Emblemhealth providing assistance to Medicare customers, and as a Medical Biller at Winthrop University Hospital handling billing functions.2015 Resume. Terry.Call Center Director
2015 Resume. Terry.Call Center DirectorTERRY O'BRIANT
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Terry O'Briant has over 25 years of experience managing call centers and providing exceptional customer service. She is currently seeking a Call Center Director position where she can utilize her expertise in developing processes to increase efficiency and performance, as well as hiring, training, motivating and mentoring staff. Her background includes roles as a Senior Team Lead and Supervisor at Blue Cross Blue Shield of North Carolina, where she oversaw call center operations and implemented changes to promote effectiveness.Dowells-Coble_Retha billing (1)
Dowells-Coble_Retha billing (1)Retha Dowells-Coble
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This document provides a summary of Retha D. Dowells-Coble's work experience and qualifications. She has over 15 years of experience in medical billing, claims processing, and customer service roles. Her experience includes working as a Medicare Appeals Specialist, Reimbursement Specialist, and Customer Service Representative for various medical device and staffing companies. She also has non-profit management experience as the Executive Director for her self-founded non-profit organization.JOHN RAZO 2015 RESUME
- 1. John L. Razo 7745 Reseda Blvd., Apt. 20 Reseda, CA. 91335 john.razo@gmail.com 818-881-7603 HIGHLIGHTS OF QUALIFICATIONS: 則 Excellent oral, written and interpersonal communication skills; strong organizational, analytical and research skills with the ability to produce results. 則 Pro鍖ciency with medical terminology (ICD9CM/CPT coding), medical billing, claims processing, adjusting and auditing of complex claim issues. 則 Extensive experience with supervision, business analysis, project coordination and management with proven results. 2003 - 2015 Claims Adjuster, Health Net, Woodland Hills, California. Under minimal supervision and increasing responsibilities, determined policyholders' level of bene鍖ts for adjustment requests pertaining to underpayments, overpayments, rebilling, collection, stop loss, claims in litigation, and maximum co-payment issues. Additional responsibilities include completing projects assigned by management that are related to exceeding departmental goals. 2000 2003 Claims Adjuster, Meridian Healthcare Management, Woodland Hills, California. Processed adjustment requests pertaining to overpayment, underpayment, contract, bene鍖t and eligibility issues. Researched, investigated and resolved administrative complaints and appeals. Additional responsibilities included assigned projects, system testing, documenting and reporting results to management within a cross functional team. 1995 1999 Supervisor of Adjustment Unit, Prudential Healthcare, Los Angeles, California. Supervised 20 examiners in processing of multiple plan adjustments. Identi鍖ed trends related to procedures, quality and production and as a result, reduced incoming work鍖ow by 50% in 12 months. Additional responsibilities included assigning work, monitoring performance, providing continuous cross training, updating policies, implementing changes, staf鍖ng, performance reviews, and a liaison between internal and external customers. Based on forecasting, created, researched and maintained tracking database to facilitate in managing projects related to department objectives.
- 2. 1994 - 1995 Auditing Coach and Assistant Supervisor, Prudential Insurance, Los Angeles, Provided coaching advice and guidance to examiners and conducted quality review of performance while collecting data for feedback and training. In addition, assisted supervisor in administrative responsibilities such as attendance, work assignments and performance reviews. 1990 1994 Project Coordinator and Analyst, Prudential Insurance, Woodland Hills, California, With forecasting team, identi鍖ed, evaluated and documented business needs and objectives and reviewed current department processes and procedures that were counterproductive to these objectives. Conducting secondary research using a variety of services including maintaining tracking databases, presented information to management with possible risks involved. With management approval, worked within a team implementing, coordinating and managing projects that were essential to achieving objectives 1989 - 1990 Health Services Coordinator. Prudential Insurance, Woodland Hills, California Supported activities of department: entering authorizations, assuring timely and accurate inpatient discharges. Assisted clinical review nurses with administrative responsibilities. 1987 1989 Claims Examiner, Prudential Insurance, Woodland Hills, California Processing of HMO, POS, PPO and Indemnity claims. Met and exceeded production standard of 75 claims per day. Processed adjustment issues for underpayments, overpayments, contract and collection issues. On a business need basis, assisted call center with incoming member and provider inquiries. Volunteered and assisted in the ongoing training of new examiners placed within department at conclusion of training class.