Compliance Administrator Resume Example

Process Workers Compensation Claims in their entirety.

• Create Appeal Packets Management.
• Call and obtain Bill Status.
• Work closely with 100+ Insurance Companies and Adjusters, to obtain Moderate Maximum Reimbursement Marketing.
• Work closely with hospital facilities to obtain Workers Compensation Claim information Excellent.
• Request and acquire all necessary documentation from Hospital Recruiting facilities(clients).
• Validate all information provided from client to create Claim packet and Advanced send to payer for processing Training.
• Review and apply PPO Contracts.
• Review and apply State Fee Schedules(Utah, Texas, Arizona, and Advanced Missouri).
• Follow State guidelines for Timely Filing(If applicable) Medical Billing.
• Mentoring fellow team members and training when necessary.
• Conducting timely and thorough phone calls to Insurance Companies to Advanced ensure bill has been received and obtains all necessary supporting documentation.
• Add Rev Codes and CPT codes to accounts, when needed.
• Generate Total Billed Charges for claims according to REV Codes and their billed charges.
• Create an expected amount according to the states Fee Schedule and the billed amount from hospital.
• Multi-Level Phone Calls.
• Working closely with a small team to process bills in a timely manner,.
• Contacting clients and setting up meetings, either within an office environment or in clients' homes or business premises.
• Conducting in-depth reviews of clients' financial circumstances, current provision and future aims.
• Analyzing information and preparing plans best suited to individual clients' requirements.
• Completing risk analyses.
• Researching the marketplace and providing clients with information on new and existing products and services.
• Designing financial strategies.
• Assisting clients to make informed decisions.
• Researching information from various sources, including providers of financial products.
• Reviewing and responding to clients changing needs and financial circumstances.
• Promoting and selling financial products to meet given or negotiated sales targets.
• Negotiating with product suppliers for the best possible rates.
• Liaising with head office and financial services providers.
• Communicating with other professionals, such as 3rd Party Vendors.
• Keeping up to date with financial products and legislation.
• Producing financial reports.
• Contacting clients with news of new financial products or changes to legislation that may affect their savings and investments.

• Managed quality assurance program, including on-site evaluations, internal audits and customer surveys.
• Maintained excellent attendance record, consistently arriving to work on time.
• Resolved conflicts and negotiated mutually beneficial agreements between parties.
• Drove operational improvements which resulted in savings and improved profit margins.
• Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately.

• Oversaw all aspects of equipment installation, maintenance, and repair for both internal and external services.
• Led facility management staff and consultants in producing business plan that focused on all aspects of facility operations, including setting priorities and job assignments.
• Skillfully managed facility operations.
• Established efficient workflow processes, monitored daily productivity and implemented modifications to improve overall effectiveness of personnel and activities.
• Managed supervisor itinerary and appointments and streamlined scheduling procedures.
• Tracked and recorded expenses and reconciled accounts to maintain accurate, current and compliant financial records.
• Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.