Manager Insurance
Resume:
Title:MIS Manager
********@***.***
Document
Source below
NAME: DIANE FIELD
ADDRESS:
CITY: Warwick
STATE/PROVINCE: RI
ZIP/POSTAL CODE: 02886
COUNTRY: USA
EMAIL: ********@***.***
PHONE: 000*******
CANDIDATE ID: N/A
CITIZENSHIP: US
Citizen
EDUCATION: Not Entered
EXPERIENCE: Not Entered
WILL RELOCATE: Not Entered
RELOCATION INFO: Not Entered
JOB WANTED: Not Entered
HOMEPAGE:
HOTSKILLS:
ESUME
Diane Field
206 Long View Drive
Warwick, RI 02886
********@***.***
PROFESSIONAL EXPERIENCE
(
May 1993
-Present)
MIS Manager, Rhode Island Managed Eye Care, Inc.; Warwick, RI
Maintenance of Novell 3.12 and 4.1 Network consisting of eight PC
nodes, system administration, and security.
Design, implement and maintain customized managed care medical
Insurance software written in VISUAL BASIC.
Design custom reports using CRYSTAL REPORT WRITER and fulfill all form
development needs.
Support client/server node to local carrier.
Conduct user training
Perform all information systems applications related to hardware and
software, as well as closely supervise programmer to ensure
prioritized goals are met.
Pre-authorization of services, claim review, patient appeals, provider
settlements, provider applications, provider credentialing, and
customer/provider correspondence.
Formulate and conduct software demonstrations to perspective clients,
and assist in on-site provider education- individual and group
Coordinate and statistically evaluate Patient Satisfaction Surveys.
Systems Liaison for all payors, including Blue Cross, PruCare, and
Cigna.
(
August 1991
to September 1993) Local Area Network Manager, Koch Eye
Associates Inc
.; Warwick, RI (1/93-9/93)
Responsibilities included managing a 28 node PC network including 3
remote stations, created custom reports using a fourth generation
language, developed macros to enhance work flow, and provided hardware
and software support
Manager Collection Department, Koch Eye Associates Inc.; Warwick, RI
(11/92
-5/93)
Responsibilities included creation and implementation of collection
department, managing client and Insurance company collection
activities, contacted debtors with consideration to regulations
regarding collection procedures, and dealt with third party collection
agencies.
Third Party Billing Clerk, Koch Eye Associates Inc.; Warwick, RI
(8/91
-11/92)
Responsibilities included: Intense knowledge of CPT and ICD9 codes
within the scope of Ophthalmology and Optometry. Evaluation and
management codes, modifiers, and staff training. Experience with many
carriers including Medicare, Medicaid, Blue Cross and Blue Shield,
United Health and Private Insurance companies.
Posted settlements, generated electronic and paper insurance claims,
patient billing, recall notices, appeals, patient communication and
correspondence for large practice consisting of sixteen doctors, an
anesthesiologist and surgery center.
EDUCATION:Tolland High School
; Tolland, CT Graduated 1978
Community College of Rhode
Island Courses completed: Typing 1 & 2;
Oral Communication; and Steno 1.
SOFTWARE:Wave Technology Novell Administrator; Microsoft Windows 3.11,
Lotus Ami Pro, Lotus Organizer, Lotus 123, Excel, Lotus Smart Suite,
Microsoft Office, Microsoft Word, Hijack Pro, Sidekick, Crystal Report
writer, WinWord, Word Perfect, DOS, Btrieve, ALCON Ivy Administration,
PowerPoint, Norton Utilities, PCTOOLS for Windows, PC Connect, Qmodem,
and limited use of Visual Basic, Dbase IV and DDF Builder.
REFERENCES:Available upon request
Contact this candidate