Search Resume Examples

CENTENE CORPORATION - Project Coordinator Resume Example

Customize this Resume
Aubrey James
XXX XXXXXXXXXX XXXXX, PELHAM, NY 10803
XXXXXXXXXXXXXXXXXXXXX
Ph: XXXXXXXXXXXX
Summary
To obtain a position in a department where I can expand my knowledge, work experience with the potential for growth.
Skills
  • English Language
  • Critical Thinking
  • Writing
  • Active Learning
  • Complex Problem Solving
  • Judgment and Decision Making
  • Systems Analysis
  • Computers and Electronics
  • Coordination
  • Quality Control Analysis
Experience
Project Coordinator Jul 2014Present CENTENE CORPORATION SAN ANTONIO, TX
  • Auditing contracts making sure there compensation page matches to what they are loaded for in the system to make sure they are getting paid correctly. If not sending information off to other department to get there rate corrected
  • Creating contracts and amendments 
  • Re credentialing audit 
  • initial credentialing audit 
  • Initial contract request which consist of making sure there is a need for that particular type of provider in our network. I would then create the appropriate contract . Get all necessary documents ready and send it to the provider 
  • Primary source verification. Checking all of the providers credentials match and are up to date to what they submitted to us
  • Utilize systems such as Emptoris for contract, Amysis, portico theses are company systems. Also use adobe pro, mircosoft, Websites used NPPES, DPS, Office of inspector general state and federal, SAMs, NPDB,DSHS,DADS,DEA,CLIA,COI,CAQH
Program Coordinator Jan 2013Jul 2014 CENTENE CORPORATION San Antonio, Texas
  • In the Medical Case Management for SSI and Medicaid members, I perform outreach efforts to members for health assessments to identify case management opportunities.
  • I also receive emails from Concurrent Review nurses for members that have been hospitalized.
  • Assist in Discharge planning Screenings to help identify case management opportunities.
  • Assist Case Managers with administrative work as needed, i.e., fax DME referrals, check status of waiver upgrades, and request upgrades from Service Coordinators Via email.
  • Mail welcome letters and resources based on member need.
  • Utilize systems such as CCMS, AMISYS, IMPACT PRO, Microsoft Office Excel, Email, and TRU CARE,.
Program Coordinator/ Case Manager assistant Oct 2012Jan 2013 HEALTH CARE SOLUTIONS San Antonio, Texas
  • Performed outreach calls to pregnant members to conduct health assessments.
  • Coordinated with a nurse management when case management was needed or with other departments if.
  • member was in need of assistance.
  • Utilized Multi-line Phone Systems, Computer Programs Microsoft Excel, Company programs to check eligibility.
Insurance Dec 2011Sep 2012 MCNA DENTAL San Antonio, Texas
  • Service line intake responsibilities assisting providers with questions related to claim issues, benefits, pre authorizations, referrals and, credentialing.
  • Assisting providers navigating thorough the provider portal and/or directing providers to the appropriate department.
  • Started off on the hotline then got moved over to claims unit.
  • Educating dental providers on how to submit claims correctly to prevent claim denials, and.
  • researching unpaid account receivables to make the appropriate corrections.
Care Coordinator Mar 2011Dec 2011 CARENET San Antonio, Texas
  • Phone intake responsibilities assisting Medicaid or CHIP and CHIP-Perinate members who need to be triaged.
  • Customer service assistance PCP change or demographic changes .Also taking calls from private, military insurances.
  • Phone intake responsibilities assisting clients with government assistance, child support and unemployment Mentor/train new employees that will be coming out to production floor.
Customer Service Representative Jan 2016Jan 2016 ACS, AFFILIATED COMPUTER San Antonio, TX
  • I also assisted in class trainings and assisted in evaluating QA scores.
TEMP LABOR ON DEMAND San Antonio, TX
  • Assisted with processing incoming transcripts.
  • called students to advise them what was needed to complete registration.
  • Assisted front desk when needed.
Education
Aug 2007 San Antonio College San Antonio, Texas
Love this resume? Customize this Resume

Resume Details

This is a real resume for a Project Coordinator in PELHAM, New York with experience working for such companies as Centene Corporation, Health Care Solutions, Mcna Dental. This is one of the hundreds of Project Coordinator resumes available on our site for free. Use these resumes as templates to get help creating the best Project Coordinator resume.

Previous Companies:

  • CENTENE CORPORATION
  • HEALTH CARE SOLUTIONS
  • MCNA DENTAL

Previous Job Positions:

  • Project Coordinator
  • Program Coordinator
  • Case Manager assistant
  • Insurance
  • Care Coordinator

Schools:

  • San Antonio College

The Easiest Way to Create a Professional Resume.

Create a job-winning resume in minutes.

create your resume

Similar Resumes

View More

Customer Service Rep...

Chattanooga, Tennessee

Companies Worked For:

USXpress INC, Sears Portrait Studio, Joann Fabric...

Project Specialist

OKLAHOMA, Oklahoma

Companies Worked For:

Thick Descriptions, TalentWave, SAFY Specialized A...

Product Management G...

Cincinnati, Ohio

Companies Worked For:

Standard Textile through Staffmark, Luxottica, Sun...

Lead Phlebotomist

Montague, Michigan

Companies Worked For:

Mercy Health Urgent Care Ludington, Mercy Health...

Human Resources Admi...

Chatsworth, Georgia

Companies Worked For:

Mattex USA, Xpress Global Systems, Shaw Industries...

PHLEBOTOMIST

Port St. Lucie, Florida

Companies Worked For:

Lawnwood Regional Medical Center, Insurance Expres...

Cleaner

Hampton, Virginia

Companies Worked For:

Trade Team LLC, International Marine Industrial A...

Care Coordinator

Indianapolis, Indiana

Companies Worked For:

FirstLight Home Care, Rescare, United States Post...

Get Started on Your Job-winning Resume Today!

Get all the help you need to create a professional resume in minutes. Includes thousands of pre-written examples for hundreds of jobs.

create your resume
Get Started on Your Job-winning Resume Today!