V Moorer Location: Plainfield, NJ 07062 ... e ability to pinpoint areas for improvement and redesign. PROFESSIONAL SKILLS* Extensive knowledge of Microsoft Office applications, including daily use of Word, Excel and PowerPoint for documentation, communication, and reporting purposes. * Knowledge and Experience with Regulatory Compliance Systems as Sarbanes-Oxley (SOX), Health Insurance Portability and Accountability Act (HIPAA), and Health Claims Authorization, Processing and Payment Act (HCAPPA).* Experience with exporting and querying reports from Crystal Reports, Siebel Analytical Reports and SARs Reports * Experience with NASCO, CARs and QBlue health claim processing systems.* Knowledge of healthcare claim payment ...
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K Alston Location: Edison, NJ 08817 ... iness growth. • Extensive background in Customer Service.• Entry-leveled adept Insurance Analyst. • Organized and efficient, able to multi-task.• Strong Statutory Reporting and troubleshooting abilities. • Familiar with Data Entry and Pro-Rata.• Consistently recognized and rewarded for talents. • Knowledgeable with Claims and Exposures.• Excellent verbal and written communication skills. Professional Experience A.I.G Insurance., Berkeley Heights, NJ 2006- Present Regulatory Reporting Analyst Provides complete Assumed and ceded Reinsurance processing of pro-rata and excess of loss (XOL). Additionally responsible for Workers’ Compensation; serves risk management accounts. Prepared cor ...
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K Ohara Location: Garwood, NJ 07027 ... s. Experience American International Group, Berkeley Heights, NJ12/07-presentC ommercial Excess Casualty UnderwriterUnder writing New Business Submissions and Renewal AccountsRevenues up to 25 Million Umbrella Liability Risk Analysis, Rating and DocumentationDev elop and Present New and Renewal QuotesManaging a Renewal Book of Business to Targeted Policy Count and Premium Retention RatiosWorking to Achieve Production Budgets and Hit RatiosQuarterly Marketing Meetings with South East Region BrokersDevelopin g and Maintaining Broker RelationshipsUnd erstanding and Communicating Rationale for Underwriting DecisionsIdentif ying Trends in South East TerritoryFollowi ng Underwriting Guidelines an ...
93 hits
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V Moffa Location: Princeton, NJ 08540 ... al level. Track record of reducing operating costs, improving claims management quality, managing risk and organically generating third party administration revenue. Areas of expertise include: • Claims Management • Third-Party Administration • Workers’ Compensation • Risk Management • Safety • Actuarial Management HERTZ CORPORATION 1989 – February 2008 Staff Vice President, Corporate Insurance/HCM-Pa rk Ridge, NJ (2003 – 2008) Claims Management Led roughly 430 technical and clerical staff handling 350,000 claims per year for the Hertz Corporation. Oversight of claims management for the Hertz Corporation (Hertz Rental Car and HERC (heavy equipment ...
91 hits
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J Baver Location: Medford, NJ 08055 ... B. Baver, Private Investigator & Independent Adjusting 1994 to present Investigate and handle all types of investigations for Rider Insurance Company, other entities and individuals 8/02 to 1/03 Richard Meyers & Associates Investigate and handle Self Insured Claims in the capacity of Consultant/ Independent Contractor 4/97 to 8/02 Temporary Claim Professionals Investigated and handled Auto, and General Liability Claims for Various insurance companies, TPA’s and self insured entities 8/96 to 11/96 New Jersey Department of Banking and Insurance Unsatisfied Judgment Fund ( UCJF ) I was the Excess Medical Benefits Supervisor responsible for a Staff of 5 Claims Professio ...
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T Roman Location: Somerset, NJ 08873 ... tion. Acquainted with NCQA, JCAHO, URAC, Accreditation and Guideline standards, HIPAA Compliance Guidelines, Wellness Programs and Consumer Driven Health Plans. Extensive knowledge of COBRA regulations. Excellent interpersonal, analytical, marketing, project management, leadership and technical skills. Knowledge of Third Party Claims Administration. Extensive medical, and ancillary carrier knowledge. Skills Proficient with the Benefit Point Aptus System, Microsoft Office, and HRIS (AS 400) systems. Knowledge of the EDS claims processing system, CPT and ICD-9 coding and billing. Expert knowledge of MedDecision (WinUCS) clinical data system (System Superuser), Group Wise E-mail Systems ...
87 hits
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D Basile Location: East Hanover, NJ 07936 ... Home Phone (973) 887-2647 Dom0459@optonlin e.net Employment : 2004 to present Overland Solutions Inc 103 Executive Drive Suite 104 New Windsor, N.Y. 12553 Premium Auditor: Audit insured's payroll journals Sui, and 941 reports for wo ...
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L Petronzio Location: Freehold, NJ 07728 ... ntal, vision, disability, life, etc.) review and processing phone messages/faxes, building spreadsheets, managing outstanding issues, new business processing, handling service and claim issues, communicating with clients/brokers/ insurance carriers, etc., maintaining vendor supplies, and processing Medicare and Individual applications. 3/5/2007 - 8/18/2007 Robert Wood Johnson Hospital Hamilton, NJ Benefit Administrator - Responsible for all benefit administration for over 1900 employees. The responsibilities include, maintaining benefit programs (medical, dental, vision, prescription, life insurance). Establish and coordinate daily relationships with third party administrators, vendors a ...
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D Kleschinsky Location: Freehold, NJ 07728 ... iting and closing procedures with over 30 years experience.Profi cient in MS Excel, Word, Access and multiple audit software programsExcellen t communication, organizational and analytical skills.Professio nal Experience2004- 2009Fidelity National FinancialJackson ville, FLSenior Agency AuditorAudits conducted in accordance with standard operating procedures and divisional departmental policies which included bank reconciliations, underwriting, and closing practice review for agent base of business in an assigned region. Timely and accurate reporting, communicating areas covered along with findings that warrant special attention. Provide in depth training for agent personnel, agency manag ...
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M Thomas Location: Newark, NJ 07103 ... -present Magellan Behavioral Health Parsippany, NJ Claims Specialist II Provide benefits, authorizations, and exceptional customer service for all Horizon BCBS mental health and substance abuse providers and members. Accurately process behavioral health claims and initiate appeals for Horizon BCBS members and mental health care providers. 2/05-6/06 One Call Medical Parsippany, NJ Referral / Scheduling Agent Handled all incoming and outgoing calls related to scheduling MRI’s, CT’s and EMG’s for patients at centers in company network. Contacted patients, physicians, insurance companies and designated medical providers to arrang ...
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