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Thick Descriptions - Project Specialist Resume Example

Ivoritca Osost-mernjhan
XXXX XX XXXXX XXXXXX, OKLAHOMA, OK 73120
Ph: XXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Professional Summary

Service-oriented Customer Service Representative with a 10 year background in Claims Management. Core competencies include Problem Solving, Research and Compliance, as well as excellent communication and time management skills. Handles tasks with accuracy and efficiency.

Skills
  • Customer and Personal Service
  • Active Listening
  • Claim Management 
  • Critical Thinking
  • Judgment and Decision Making
  • Complex Problem Solving
  • Negotiation
  • Quality Control Analysis
  • Load & Execute Contracts
  • Production and Processing
  • Insurance
  • Medical Records and Health Information 
Experience
Project Specialist Mar 2018Sep 2018 Thick Descriptions Oklahoma City, OK
  • Set goals and deadlines for the department.
  • Acquire, distribute and store supplies.
  • Prepare and process requisitions and purchase orders for supplies and equipment.
  • Maintain records of goods ordered and received.
  • Prepare bid awards requiring board approval.
Healthcare Health Care & Insurance Operations Associate May 2016Feb 2017 TalentWave Denver, CO
  • Load and Execute Contracts involving Providers and United Health Care.
  • Identify, compile, abstract, and code patient data, using standard classification systems.
  • Protect the security of medical records to ensure that confidentiality is maintained.
  • TIN Id's maintenance involving Providers, Hospitals and Small Medical Groups 
  • Determine various Fee Schedules needed for various Market specifics Groups
Foster Provider Feb 2012Oct 2016 SAFY -Specialized Alternative for Families & Youth Oklahoma City, OK
  • Serve as liaisons between students, homes, schools, family services, child guidance clinics, courts, protective services, doctors, and other contacts, to help children who face problems such as disabilities, abuse, or poverty.
  • Counsel with child regarding problems, behaviors and trauma to determine whether further action is required.
  • Provide, find, or arrange for support services, such as child care, homemaker service, prenatal care, substance abuse treatment, job training, counseling, or parenting classes, to prevent more serious problems from developing.
  • Arrange for medical, psychiatric, and other tests that may disclose causes of difficulties and indicate remedial measures.
Customer Service Representative, Claims Feb 2013Jul 2014 Gallagher Basset Services, Inc Edmond, OK
    • Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
    • Analyze information gathered by investigation, and report findings and recommendations.
    • Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
    • Collect evidence to support contested claims in court.
    Claims Examiner Feb 2012Feb 2013 The Midlands Corporation Oklahoma City, OK
    • Resolve complex, severe exposure claims, using high service oriented file handling.
    • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
    • Confer with legal counsel on claims requiring litigation.
    • Pay and process claims within designated authority level.
    Claims Specialist Apr 2004Jan 2011 Claims Management Resources Oklahoma City, OK
    • Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
    • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
    • Confer with legal counsel on claims requiring litigation.
    Education
    Certificate Jun 1998 Peralta Community College Oakland, CA

      Construction Management

      Certificate Mar 1987 Louisiana Business College Monroe, LA
      • Business
      Certified Billing & Coding Specialist Medcerts -Michigan Oklahoma City, OK

        CBCS – Certified Billing & Coding Specialist

        CEHRS -Certified Electronic Health Records Specialist

        Graduation Date: February 2019

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        Resume Details

        This is a real resume for a Project Specialist in OKLAHOMA, Oklahoma with experience working for such companies as Thick Descriptions, Talentwave, Safy Specialized Alternative For Families Youth. This is one of the hundreds of Project Specialist resumes available on our site for free. Use these resumes as templates to get help creating the best Project Specialist resume.

        Previous Companies:

        • Thick Descriptions
        • TalentWave
        • SAFY Specialized Alternative for Families Youth

        Previous Job Positions:

        • Project Specialist
        • Customer Service Representative
        • Claims
        • Claims Examiner
        • Claims Specialist

        Schools:

        • Peralta Community College
        • Louisiana Business College
        • Medcerts -Michigan

        Level of Education:

        • Certificate
        • Certified Billing & Coding Specialist

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