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Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
:
Professional Summary

Performance driven Management professional with strong leadership and relationship-building skills. Organized and diligent, with excellent written, oral and interpersonal communication skills.

Bookkeeper with key strengths in planning, problem solving and customer relations. Familiar with financial reconciliations, general ledgers and financial reporting.

Education
Centene Corporation , Expected in 2015 Certification : Management Training - GPA :

Coursework in Seven Habits of highly Effective People

Chicago State University Chicago, IL Expected in 2013 Bachelor of Arts : Business Administration - GPA :
, Expected in 2012 : Illinois Notary Public - GPA :
Skill Highlights
  • Staffing management ability
  • Proven patience and self-discipline
  • Patient-oriented
  • Personal and professional integrity
  • Sound decision making
  • Critical thinking proficiency
  • Relationship and team building
  • Financial aptitude
  • Staff training and development
  • Claims analysis and review specialist
Professional Experience
Cdw - Supervisor/Member & Provider Services Call Center
Palo Alto, CA, 11/2014 - Current
  • Addressed customer service inquiries in a timely and accurate fashion.
  • Participate in interdepartmental communication meetings to resolve gaps in communication and resolve inefficiencies
  • Reviewed and approved time cards for processing by payroll department.
  • Perform call observations and evaluations for quality control
  • Formulated and enforced Service Center policies, procedures and quality assurance measures.
  • Assisted with the development of the call center's operations, quality and training processes.
  • Trained staff on how to improve customer interactions.
  • Processed sensitive grievance and Appeals complaints with DOI department for resolution
  • Provided thorough supervision for day-to-day operations of rep's in accordance with set policies and guidelines.
  • Jumped in to fill gaps for weekend coverage rotation when necessary.
  • Regularly evaluated employee performance, provided feedback and assisted, coached and disciplined staff as needed.
  • Diligently monitored the QA (Quality Assurance) program to improve performance and maintain high standards of customer service.
  • Minimized staff turnover through appropriate selection, orientation, training, staff education and development.
  • Organized and led weekly staff huddles meetings with 20 team members.
  • Built customer loyalty by placing follow-up calls for customers who reported product issues.
HCR Manor Care - Administration/ Business Office Manager
City, STATE, 10/2005 - 11/2014
  • Direct the overall Business Office activities in accordance with current applicable federal, state, and local standards, guidelines and regulations
  • Consult daily with Department Heads and Administrator regarding any financial or customer service issues resulting in Involuntary Discharge Planning
  • Led the Reception staff, Account payable and Payroll clerks
  • Conduct monthly A/R reviews for updated status on all collection efforts concerning Private pay, Medicare, Insurance and Medicaid billing
  • Main contact for maintaining Internal Audit policy and procedures
  • Consistently maintaining company goal in leading cash collection goals 95%
  • Managed all necessary overall bookkeeping logs for accuracy and compliance
  • Assure proper administrative procedures are maintained with focuses on legal and residents rights Resident Trust Fund
  • Reconciler Review and provide private pay refund checks
  • Cooperated with other health related agencies and organizations in community activities.
  • Provided thorough supervision for day-to-day operations of facility in accordance with set policies and guidelines.
  • Jumped in to fill gaps for on call rotation when necessary.
  • Established and maintained positive relationships with government regulators, residents, families, other area health care providers, physicians and community at large.
  • Developed and managed budget and revenue expectations while actively seeking ways to eliminate or reduce expenses.
  • Observed strict confidentiality and safeguarded all patient-related information.
  • Reviewed and approved time cards for processing by payroll department
  • .Maintained accounts receivable documentation electronically and on paper.
  • Processed bank reconciliations and financial reports to verify practice of proper due diligence.
  • Handled cash and deposits using the proper accounting procedures and documentation.
  • Researched and resolved collections and billing disputes with tact and efficiency.
Illinois Collection Service - Medical Collection/Insurance Biller
City, STATE, 07/2003 - 10/2005
  • Arrange and set acceptable payment plans on non-insurance holders medical bills
  • Execute and bill for co-insurance and out of pocket deductibles due the hospital
  • Perform skip tracing duties and retrieve credit reports on bad debt accounts making decisions on reporting adversely to credit bureaus
  • Process accounts for legal action that show ability for suit or liens
  • Maintained billing duties to various insurance carriers to process HCFA/UB92 for payment
  • Post payments via credit cards and checks by phone
  • Addressed low income and hardship debtors with charity programs offered by the hospitals
  • Consistently achieve group $850,000 goal and individual goals of $50,000 per month.
United Healthcare - Contract Analyst
City, STATE, 09/2000 - 10/2002
  • Handled provider related inquiries Resolved claim processing issues and prepared status reports
  • Prepared tracking graphs for complex fee schedules Investigated and evaluated activities performed by the claim processing unit
  • Collaborated with Senior Network Account Managers to identify potential load issues and recommend corrections Tracked audits on unpaid check issues
  • Communicated key provider disruption issues utilizing the Network Change Database.
United Healthcare - Provider System Specialist
City, STATE, 08/1998 - 09/2000
  • Created provider records in all systems for all physicians and ancillaries
  • Maintained the data entry of physician re-accreditation applications
  • Updated physician demographic and contract information on internal database to assist with provider directory
  • Communicated/educated internal staff of appropriate information needed to complete the data entry process
  • Responsible for maintaining provider directories and other marketing tools Responsible for assisting supervisor with unit production updates.
Skills

Windows, Microsoft word, Power Point, Excel, Word, Word Perfect, Administrative, Medical Manager, Medicare DDE, Kronos, Trucare, Portico, Emdeon, Medicaid Rev System, Ability Medicare, Resident Fund Management System, Allscripts, Matrix, Wound Rounds, HSSI, ADP E-Time, Billing, Bookkeeping, Call Center , Coaching , Credit Collections, Customer service, Data entry, Database Management, Discharge Planning, Financial , Graphs, Insurance Internal Audit, legal, marketing, Team meetings, Networking, Payroll, Quality control, reporting, Supervisor

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Resume Overview

School Attended

  • Centene Corporation
  • Chicago State University

Job Titles Held:

  • Supervisor/Member & Provider Services Call Center
  • Administration/ Business Office Manager
  • Medical Collection/Insurance Biller
  • Contract Analyst
  • Provider System Specialist

Degrees

  • Certification
  • Bachelor of Arts

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