High School Project
Resume:
Luis Lara
Email: ********@**********.***
Address:
City: Tarrytown
State: NY
Zip: 10591
Country: USA
Phone: 914-***-****
Skill Level: Any
Salary Range:
Primary Skills/Experience:
High-performing, strategic thinking professional with more than 3 years of experience as Medical Claims Auditor in Healthcare Industry Performed and conducted Claim Analysis for the benefit of the practice and clients. Possess excellent written and verbal communication skills; bilingual leader: English and Spanish Ability to work in a team environment as well as work independently with minimum supervision Experienced in providing Operations Support; ability to analyze processes and procedures, develop, implement and monitor new processes and procedures to assure optimal performance Excel at communicating with stakeholders at all levels to provide accurate reporting and information regarding the ongoing projects and initiatives
Educational Background:
High School Dipolma from Devry University, New York City NY 1/2001 to 6/2012 (Project Management)
High School Dipolma from Devry University, New York City NY 1/2001 to 10/2012
High School Dipolma from Fordham University, New York City NY 1/2001 to 10/2012
High School Dipolma from The College of Westchester, New York City NY 1/2001 to 10/2012
Job History / Details:
Professional Summary
High-performing, strategic thinking professional with more than 3 years of experience as Medical Claims Auditor in Healthcare Industry
Performed and conducted Claim Analysis for the benefit of the practice and clients.
Possess excellent written and verbal communication skills; bilingual leader: English and Spanish
Ability to work in a team environment as well as work independently with minimum supervision
Experienced in providing Operations Support; ability to analyze processes and procedures, develop, implement and monitor new processes and procedures to assure optimal performance
Excel at communicating with stakeholders at all levels to provide accurate reporting and information regarding the ongoing projects and initiatives
Education and Training
2012 Villanova University Online Program,
Master Certificate in Business Analysis Business Analysis
2011 Devry University New York City, NY
Master of Business Administration Project Management
2009 Fordham University West Harrison, NY
Bachelor of Arts Organizational Leadership
2007 The College of Westchester White Plains, NY
Associate of Applied Science Accounting
Skill Highlights
XP/VISTA applications, MS Office Suite (Word, Excel, Access, PowerPoint), MS Project,
Strong knowledge of PMBOK Guide and Standards
Professional Experience
August 2009 to Current
OrthoNet LLC White Plains, NY
Medical Claims Auditor
Performed data entry of claims into an electronic claiming system
Review claims for accuracy and thoroughness; consistently meet and/or surpass claims adjudication minimum production requirements and adhere to policies and procedures in place by company
Identify trends based upon the quality reviews and audits; document as needed and initiate corrective actions
Track project progress and create reports; quickly develop problem resolution strategies and oversee claims process to ensure effectiveness of corrective actions
Prepare concise but thorough documentation and audit reports, including written corrective action recommendations
Educates administrative and claim processors staff in the correction of these deficiencies
May 2007 to May 2009
Hudson Valley Bank Elmsford, NY
Bank Teller
Provided thorough, courteous service to diverse range of customers on a daily basis; optimized satisfaction levels during such financial exchanges as term, night, & mail deposits, retirement savings plan contributions, and automated teller transactions
Drove sales of travelers and cashier's checks, savings bonds, and money orders to average of 50 customers per day; utilized computerized profile information to target customers
Received mortgage, loan, or public utility bill payments; accurately verified due dates and amounts
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