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Q&a Representative Resume

Montvale, NJ

Managed Care Professional

A results driven Managed Care Professional with progressive experience in physician and facility credentialing, contract preparation and administration. Team player with ability to interact effectively at all organizational levels. Ability to excel in high volume, demanding work environment.

Experience

Confidential, Montvale, NJ
Provider of expert care for patients and top-level support for referring physicians through a network of MRI imaging facilities nationwide.

Contracts and Credentialing Coordinator

  • Responsible for review and preparation of new contracts for implementation.
  • Communicated with insurance providers to facilitate submission of credentialing and re-credentialing insurance application information and related contracting materials.
  • Maintained physician and facility credentialing files, and database tracking information.
  • Maintained current credentials for all active providers.
  • Telephone follow-up with RAMIC site managers with regards to facility credentialing; follow-up with physician contacts with regards to physician credentialing.

Q&A Representative

  • Responsible for the quality and processing of patient information and medical claims in Medical Manager (medical software database).

Confidential, Suffern, NY
A Medical group practice of Cardiologists.

Front Desk Medical Biller

  • Responsibilities included charge entry of super bills, coding, posting patient payments.
  • Check in/out of all patients; scheduled patients’ follow-up appointments or special tests if requested.
  • Collected co-payments from patients and verified insurance coverage.

Confidential, New York, NY
A newspaper, periodical, and book publisher its publications consisted of consumer and trade magazines, reference books, and educational materials and services.

Publishing Systems Associate

  • Responsible for proofreading against copy, using standardized code to mark grammatical or typographical errors that appeared in proof.
  • Performed extensive research for new articles to be published.
  • Created a Microsoft Access database which cataloged and tracked changes of information for every article (over 25,000 articles) published in the Funk & Wagnalls Encyclopedia.
  • Converted encyclopedia articles into various customer-requested formats (i.e. HTML) using Microsoft Word and FrameMaker software.

Confidential, Montvale, NJ
Known for ClubCar (golf cars and utility, transportation and rough-terrain vehicles), Shlage mechanical locks, and air compressors, compressed-air dryers and filters, air motors and material-handling equipment.

Analyst

  • Responsible for the administration of Ingersoll-Rand’s Risk Insurance Management System (RIMS), claims tracking, aggregate reporting, tracking of environmental payments, and plaintiff count and payments made to law firms.
  • Administered the Global Property Program. Duties included the renewal process, policy updates, field inquiries, certificates of insurance, administration and updating of the RIMS property module.
  • Compiled documentation and information to meet underwriter requirements for the company’s insurance renewal book.

Confidential, Mahwah, NJ
Institution of Higher Education.

Services Specialist, School of Business

  • Obtained, scheduled, and analyzed course planning information for the School of Business.
  • Developed and maintained database programs that tracked business students’ academic progress.
  • Computer liaison between faculty and technical staff.

Computer Skills

Microsoft Word ,Excel, Outlook, Medical Manager, SyMed, FrameMaker,Digital Office Manager (DOM), Microsoft Access.

Education

Confidential, Newark, NJ MS, Business Management
Confidential, Mahwah, NJ BS, Business Administration

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