Representative Senior Resume Samples
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Representative Senior Resume Samples
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EK
E Kuvalis
Elliot
Kuvalis
361 Jaskolski Glens
San Francisco
CA
+1 (555) 819 9622
361 Jaskolski Glens
San Francisco
CA
Phone
p
+1 (555) 819 9622
Experience
Experience
Phoenix, AZ
Senior Appeals Representative
Phoenix, AZ
McClure, Lang and Barrows
Phoenix, AZ
Senior Appeals Representative
- Prioritizes workflow on a consistent basis, applies key HIPAA and CMS guidelines in daily workflow, and meets turnaround times for assigned cases
- May research and resolve written Department of Insurance complaints and complex or multi-issue provider complaints submitted by consumers and physicians / providers
- Positions in this function are responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances
- Research and investigate complex issues through the use of multiple internal computer databases, external computer systems and supporting technology, such as scanning / imaging
- Independently reviews the members’ case file to determine if representative / appellant is authorized party and if complaint is valid. These may include: Medical benefits, eligibility, claim payment, deductible limits and co-payments, pharmacy benefits, eligibility and claims, and billing and enrollment inquires
- Partners with all service delivery functions ( i.e. clinical, claims, billing and enrollment) to answer member questions / or works with others to resolve escalated issues
- Maintains system documentation on the tracking and monitoring of all cases as well as the final disposition to ensure overall compliance with Medicare regulations
Phoenix, AZ
Senior Provider Service Representative
Phoenix, AZ
Fay-Rolfson
Phoenix, AZ
Senior Provider Service Representative
- Reviews and facilitates provider network approval of ID cards for network accuracy and completeness
- Provide standard agreements upon request from providers or pursuant to contracting initiatives and assist with contracting projects
- Perform contract routing duties as assigned including logging receipt of contracts and ensuring the contracts are properly executed
- Plan, prioritize, organize and complete work to meet established objectives
- Monitors discount guarantees for the customers and network performance guarantees for the PPOs. Orders PPO directories, if necessary
- Stay abreast of industry trends related to pharmacy benefits management and proactively identify risks and opportunities within network pharmacy relationships
- Work is frequently completed without established procedures
present
Detroit, MI
Senior Governmental Affairs Representative
Detroit, MI
Erdman Inc
present
Detroit, MI
Senior Governmental Affairs Representative
present
- Manage the completion of own work assignments and coordinate activities with the business unit client group and the Governmental Affairs manager
- Establish working relationships with respective business units to identify specific policy concerns as they relate to business objectives
- Provide advice and counsel to senior management, including the Executive Office, on high priority issues within their issue portfolio
- Represent business unit/enterprise interests before policymakers and be lead advocate for same
- Create and lead ad-hoc groups which focus on key issues
- Develop long-term relationships and enlist the support of key governmental leaders and staff in pursuit of corporate objectives
- Provide first line of defense against problematic policy initiatives that may negatively impact the company
Education
Education
Bachelor’s Degree in Life Sciences
Bachelor’s Degree in Life Sciences
University of California, Berkeley
Bachelor’s Degree in Life Sciences
Skills
Skills
- Strong basic math skills
- Proven ability to prioritize, hit multiple, and competing deadlines
- Excellent oral/written communication skills and reading comprehension
- Ability to adapt to a dynamic and changing work environment and work in cross functional teams
- Demonstrated history of a high level of attention to detail and customer service
- Experience and comfortable in conflict resolution
- Strong interpersonal and relationship building skills
- Experience with our product is
- At least 2-3 years of practical experience in sales
15 Representative Senior resume templates
Read our complete resume writing guides
1
Senior Warranty & Repairables Representative Resume Examples & Samples
- Administrate customer parts exchanges
- Collect and forward import documentation of returning units to the Import/Export group
- Process customer warranty claims
- Generate weekly and monthly status reports
- Identify process improvement opportunities
- Subject matter expert on processing repairables and resolving exceptional issues
- Process warranty disputes
- Select a function
- Environment, Health & Safety
- Facilities
- International Trade Compliance
- Operations
- Other
- Procurement
2
Senior Dispute Representative Resume Examples & Samples
- Reviewing claimant spend-patterns, transaction data, available online data, and leveraging knowledge of industry fraud trends to determine if claim is valid or fraudulent
- Assessing claimant eligibility for access to affected funds during the dispute recovery process in accordance with US consumer laws
- Reviewing evidence presented and leveraging Visa's dispute resolution management rules to determine the validity of each claim and its potential for recovery
- Utilizing Visa's chargeback process to attempt recovery on behalf of Visa DPS' Issuing Clients, ensuring that chargebacks are submitted in accordance with Visa's International Operating Regulations, and that all required evidentiary and technical conditions and requirements are met
- When chargebacks are challenged by the opposing party via a representment, review the new evidence to assess its validity and either resolve the claim or counter-challenge the representment through Visa's pre-arbitration, pre-compliance, arbitration, or compliance process
- Analysts will manage all complex dispute types, primarily non-fraud claims
- Non-fraud claim submissions without approval are capped at $1000 per claim until proficiency is demonstrated
- 5 years' experience working in a merchant acquiring, card issuing, or back office banking environment, and a minimum of 2 years of experience in a dispute resolution management or loss recovery role
- Detailed knowledge of Visa's International Operating Regulations, industry trends, and industry best practices
- Detailed knowledge of US Federal regulations E and Z
- A proven track record for making sound decisions based on available evidence, managing both short and long-term goals, and achieving high quality operational results
- Qualified individuals will possess the initiative and judgment to ensure customer expectations and service levels are exceeded
- Exceptional verbal, written, and interpersonal communication skills are required
- The ability to occasionally work off hours to support the global team
3
Senior Dispute Representative Resume Examples & Samples
- Reviewing evidence presented and leveraging Visa’s dispute resolution management rules to determine the validity of each claim and its potential for recovery
- Utilizing Visa’s chargeback process to attempt recovery on behalf of Visa DPS’ Issuing Clients, ensuring that chargebacks are submitted in accordance with Visa’s International Operating Regulations, and that all required evidentiary and technical conditions and requirements are met
- When chargebacks are challenged by the opposing party via a representment, collaborate with senior staff to review the new evidence to assess its validity and either resolve the claim or counter-challenge the representment through Visa’s pre-arbitration, pre-compliance, arbitration, or compliance process
- Work is limited to point of sale and e-commerce fraud and negative balance management claims only
- Submissions without approval are capped at $1000 per claim at the associate level
- 3+ years’ experience working in banking or a merchant acquiring, card issuing, or back office banking environment
- Ideally 1+ years of experience in a dispute resolution management or loss recovery role, although this is not a requirement
- A fundamental knowledge of Visa’s International Operating Regulations, industry trends, and industry best practices
4
Senior Controls Representative Resume Examples & Samples
- 1 to 3 years of related experience
- Good knowledge and understanding of project management principles and processes
- Good understanding of the business unit’s risk and regulatory requirements
- Understanding of Bank and industry standards and practices
- Good investigation skills, strong technical skills writing macros (VBA/Excel)
- Strong interpersonal skills, with ability to train, instruct and consult others [OR Coaching, mentoring and training skills]
5
Senior Investigation Representative Resume Examples & Samples
- Higher education
- Fluent in both written and spoken English
- Analytical skills- ability to analyze complex and variable issues
- Strong communication and diplomacy skills
- Very good work organization; punctuality and timeliness
6
Senior Governmental Affairs Representative Resume Examples & Samples
- Be an advocate for Caterpillar’s interests on a variety of issues before members of the U.S. House, Senate, Administration officials, and respective staff members
- Represent the company with business, industry, and trade groups in shaping and influencing public policy
- Responsible for a specific "portfolio" of issues. Issue responsibilities will focus on some of the key energy related issues related to our natural gas and turbine business
- Establish working relationships with respective business units to identify specific policy concerns as they relate to business objectives
- Represent business unit/enterprise interests before policymakers and be lead advocate for same
- Provide advice and counsel to senior management, including the Executive Office, on high priority issues within their issue portfolio
- Represent Caterpillar’s interests in various coalitions, associations, etc.; leverage same in support of company priorities
- Provide first line of defense against problematic policy initiatives that may negatively impact the company
- Identify emerging legislative issues/policy trends which could affect corporate objectives
- Develop long-term relationships and enlist the support of key governmental leaders and staff in pursuit of corporate objectives
- Create and lead ad-hoc groups which focus on key issues
- Provide advice and counsel to the Governmental Affairs Manager on political campaigns and elections, particularly in regard to any company (PAC) support or involvement
- For all practical purposes, be "the company" before lawmakers and the Administration. Therefore, at all times maintain Caterpillar’s reputation for honesty, integrity and excellence
- Manage the completion of own work assignments and coordinate activities with the business unit client group and the Governmental Affairs manager
- Face complex issues which may differ from those typically faced within the industry or profession
- Roughly one-third of the time meet with counterparts at other companies and associations; one-third in member and staff meetings with government officials; one-third in the office
- All activities are related to advancing the company’s legislative agenda
- Establish and then monitor general policies and guidelines for projects under his/her control to ensure specific management goals are met and desired results are achieved
- Some travel required; must be willing to work evenings
- In-depth knowledge of the federal legislative and political process, as well as key issue areas. Familiarity with Caterpillar and its products/services
- Minimum 7 years of job-related experience
- Able to sort through complex issues, and work with Governmental Affairs Manager to develop strategy and tactics to accomplish policy objectives
- Able to be a strong advocate for company positions on issues
7
Senior Hrsc Representative Resume Examples & Samples
- Manage daily receipt and auditing of HR related documents
- Lead compliance tracking process of partners and employees for HR and firm initiatives
- Maintain adequate documentation of communication with employees on compliance matters
- Provide compliance reporting to leadership and clients
- Meet established quality and service level agreements
- Minimum of three years of administration experience; preferably within a professional services firm or similar environment
8
Senior Terratory Representative Resume Examples & Samples
- Demonstration and selling of products in our portfolio in a pre-set territory mostly via tenders. And in some parts of this territory, collaborative work with our distributors should be accomplished
- 3-5 years of sales experience in Health Care Sector
- Experienced about our product portfolio (esp. sutıres) and the region (esp. Çekmece KHBand Cerrahpaşa University) is an asset
- Self-disciplined, self-motivated and ambitious personality with the confidence to contribute to the success and harmony of the team
- No military obligation for male candidates
- Having a valid driving license
- Position is located in IstanbulSales
9
Senior Subcontracts Representative Resume Examples & Samples
- Assist with development of Subcontract Services Group policy and procedures
- Ensure that all subcontracting practices and procedures are in effect and compatible with proposal and/or project policies and procedures
- Train others in the function of Subcontracts Representative, with minimal supervision
- Oversee, proactively support and facilitate other Subcontracts Representative staff members to engage in continuous improvement activities
- Assist Subcontracts Manager in implementing effective Subcontract strategies to support all business lines
- Prepare, issue, and manage the bidding process
- Develop sourcing strategies for the procurement of services and commodities to support proposal pricing efforts across all business lines
- Lead and manage the evaluation process through the distribution of quotations, preparation of commercial portion of the bid tabulation, and collaboration with engineering and construction regarding the technical and constructability evaluations. Makes recommendations for selected bidder(s) and who to award
- Coordinate with engineering, estimating and construction leads to support development of scoping documents, drawings, estimate quantities, indirect cost structure and site specific construction requirements
- Use of independent judgment for resolution of construction, estimating or engineering related issues in support of assigned proposal or project effort
- Develop and issue subcontractor RFP packages and Addenda to support proposal and project pricing efforts
- Read and interpret project scopes of work and assist engineering and construction leads to determine project needs
- Collaborate with engineering, estimating and construction leads to reconcile scope requirements, quantities and overall bid conditioning
- Maintain subcontract bid tabulation including necessary cost adjustments and provide final recommendations
- 5 years of experience in a Construction, Estimating or Engineering environment in support of EPC proposal or project efforts
- Basic Analytics - Creation and Interpretation
- Strong Attention to Detail
- Basic Budget Development and Management
- Strong Communication - Written and Oral
- Strong Computer Skills - Databases and MS Office
- Strong Contract Comprehension
- Strong Data Entry
- Proficient Mathematics
- Basic Presentation Skills
- Proficient Problem Solving
- Proficient Project Process Management
- Proficient Schedule and Planning Understanding Customer focus
- Decision quality
- Ensures accountability
- Situational adaptability
10
Senior Provider Service Representative Resume Examples & Samples
- Demonstrate great depth of knowledge/skills in own function
- Plan, prioritize, organize and complete work to meet established objectives
- May coordinate work of other team members
- Corporate Savvy - Understands the organizational structure of the Company and how to produce results within that structure
- Customer Focus - Dedicated to meeting customer expectations and requirements while maintaining balance with business requirements
- Problem Solving and Prioritizing Skills - Prioritizes, anticipates and analyses problems to expedite their resolution
- Communication Skills - Strong written, verbal and presentation skills
- 1+ year of Provider Claims Processing experience
- Must be able to: MS Word - create, copy, edit, attach, save and send
- MS Outlook - manage calendar and emails
- MS Excel - manipulate a worksheet
- Previous experience with any of the following: Contract Interpretation, Provider Pricing, Medical Claims Issue Resolution, and/or Electronic Claims Processes
- Experience Resolving Escalated Customer Service Issues
- Experience successfully meeting metrics and deadlines
- Experience providing excellent customer service to key provider contacts and internal stakeholders
- Experience working with high email volume
11
Senior Provider Service Representative Resume Examples & Samples
- Be the main point of contact for contract management
- Perform contract routing duties as assigned including logging receipt of contracts and ensuring the contracts are properly executed
- Maintain, track and file provider contracts
- Provide standard agreements upon request from providers or pursuant to contracting initiatives and assist with contracting projects
- Assist with review of contracts
- Day to day contact for assigned network pharmacy partners as applicable
- Stay abreast of industry trends related to pharmacy benefits management and proactively identify risks and opportunities within network pharmacy relationships
- Partner closely with peers across different departments on strategic projects/issues to apply strategic thinking, expert situational and business knowledge and a deep understanding of the industry drivers to advance company objectives
- Support Network Relations team as requested
- Additional duties as assigned
- Experience with various software products including Microsoft Word and Excel
- Familiarity with Adobe
- Associate's or Bachelor's Degree (or higher)
- Paralegal certificate
- Experience with DocuSign
12
Senior Appeals Representative Resume Examples & Samples
- Acts as an account manager for assigned Appeals Cases and interacts extensively with the legal, regulatory affairs and other key internal stakeholders across Benefit Operations in the member issue resolution process
- Reviews, analyzes and processes policies related to claims events to determine the extent of the company's liability and entitlement
- Accountable for all phases of research and investigation and works with business partners and/or many different systems across the enterprise to reach final resolution and remediation
- Written and verbal communication with appropriate parties, including appellant, regarding appeals and/or grievance issues, implications and decisions with zero defects and with no grammatical composition and/or punctuation errors
- Analyzes and identifies trends and provides reports as necessary
- Consistently meets established productivity, schedule adherence, quality standards, and CMS standards
- Independently reviews the member’s appeal or inquiry to determine if representative/appellant is an authorized party and if complaint is valid
- Prepares case files for internal or external review such as by medical staff or outside entity
- Understands both hospital and physician claims types, and can process highly complex and unique cases with minimum assistance
- Understands key HIPPA and CMS requirements and regulatory guidelines, and is fully competent in applying to daily workflow as evidenced by meeting Turnaround Times (TAT) for assigned cases, providing accurate case file decisions and prioritizing workflow on a consistent basis
- 2+ years of experience in an Appeals and Grievance or Claims role, medical office or health insurer
- Claims knowledge and experience
- Proficient with all HIPPA guidelines
- Previous experience navigating multiple SharePoint Sites and accessing files to retrieve and validate data on a consistent basis
- Ability to create and modify documents within Microsoft Word
- Ability to create and modify spreadsheets within Microsoft Excel
- Available to work flexible schedules and extended hours including weekends on a consistent basis to meet CMS deadlines
- Proficient with CMS regulations for Chapter 13 on appeals processing standards
- Experience with Healthcare/Medical Terminology
- Working knowledge of Medicare Part C claims filing
- Working knowledge of Cosmos/Nice platforms
- Proficient in processing adjustments
- Experience working for UnitedHealth Group or United Healthcare
- Proven ability to work independently and with minimum supervision
- Excellent conflict and time management skills
- Professionally and adeptly resolve issues while under stress
- Ability to meet urgent regulatory timelines
- Demonstrate personal resilience
- Ability to handle multiple priorities
- Detail oriented, analytical and ability to problem solve
- Ability to understand and professionally explain complex medical information to providers and members in regard to their appeal concerns
- Ability to ask appropriate questions and actively listen to identify underlying questions and issues
13
Senior Provider Service Representative Resume Examples & Samples
- 3+ years of Managed Care or Medical Insurance experience
- 2+ years experience in a Claims, Customer Service or Provider Support role
- Proficient with Microsoft programs including Excel and Word
14
Senior Appeals Representative Resume Examples & Samples
- Provide expertise or general claims support by reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances
- Provide excellent customer service
- Will be working with NDB & Facets
- Will provide extensive work experience within own function
- Work is frequently completed without established procedures
- May coordinate others activities
- 2+ years of experience working with Claims, Customer Service or Researching, Analyzing and solving Appeals and Grievances
- 2+ years of work experience with computers and Windows PC applications
- Experience working with NDB - Provider Database
- Experience as a user in CSP Facets
- Ability to learn new and complex computer system applications
15
Senior Biopharmaceutical Representative Resume Examples & Samples
- Contributes to Cluster/Territory Teams Collaborates (Medical Affairs/Key Account Manager, etc.) to agree on key account plan objectives/responsibilities
- Engages with peers and District Manager to learn best practices
- Demonstrates an understanding of industry and healthcare trends, of how retail practices, clinics and hospitals operate
- Follows through on customer commitments and requests in a timely fashion
- Reports customer activity in the CRM system and ensures customer profiles are kept up-to-date
- Demonstrates an understanding of Amgen Performance 4 selling platform to satisfy customer and Amgen needs
16
Senior Biopharmaceutical Representative Resume Examples & Samples
- Two or more years of sales and/or marketing experience within pharmaceutical, biotech, healthcare, or medical device industries
- Neurology, endocrinology, hepatology, gastroenterology, or infectious diseases, and the diseases and treatments involved with these specialties
- A Bachelor’s degree in Life Sciences or Business Administration
- Core Competencies: Planning and Organizing Work Engaging Others Through Effective Communication
- Drive to Achieve Individual Leadership and Impact
17
Senior IT Service Representative Resume Examples & Samples
- To be a go-to person on our IT Services team supporting 1000+ end users primary located in the US, working closely with our global team to support other sites in Dublin, London, India and Sydney as necessary
- Be a team lead or mentor to our junior level teammates
- Manage PC inventory and build/image/deploy new hire desks with computer, phone, headsets, and other system requirements as needed
- Troubleshoot and resolve IT related issues with desktops and laptops, printers, mobile devices, data cabling, and other technology peripherals
- Maintain, update and create documentation where necessary
- Coordination of on-site repairs of warranty and non-warranty hardware
- Constantly strive to improve our working processes and procedures
- Manage stock levels and take the lead on purchasing to ensure offices are well equipped and software licences are purchased as needed. This will involve managing existing relationships with vendors and exploring alternatives for best pricing
- Work with other business units outside of IT on large adds/moves/changes
18
Business Service Representative Senior Resume Examples & Samples
- Taking ownership of customer issues from beginning to end
- Provide customer recommendations based on account trends and analysis
- Handle account changes and submission requests
- Handle billing and invoice queries
- Maintain account logs (member number, products, handling procedures, reports)
- Verify account information and member number status
- Credit file queries and research
- First level technical support
- Produce, request or maintain customer facing reports
- Product familiarity/knowledge, assistance and training
- Interact with all Equifax departments as needed to resolve customer requests
- Join customer and sales trainings, meetings as needed to identify customer needs, explain/ promote and sell various products and services
- Support sales team
- Customer changes outside of normal business hours
- Minimum two years credit industry knowledge
- PC skills – Word/Excel/PowerPoint
- Able to work multiple schedules between 8am -8pm ET
19
Senior Field Construction Management Representative Resume Examples & Samples
- Leads and manages the construction project team through site mobilization, execution, and demobilization activities, consistent with established project delivery processes to ensure the orderly, efficient, and timely completion of the project scope in accordance with requirements specified in the contract documents
- Onsite activities may include construction supervision, field administration, procurement, and field engineering
- Completes the scope of work to the satisfaction of the client, while simultaneously ensuring that CH2M HILL’s HS&E, quality, financial, risk management; business and policy expectations are met
- Bachelor’s degree in an applicable discipline preferred, or equivalent experience
- 12 to 14 years of progressively more responsible experience preferred (if holds bachelor’s degree, then 6 years preferred)
20
Senior Chargeback Representative Resume Examples & Samples
- Responsible for investigating and responding to credit card charges disputed by the credit card holder by using internal and vendor systems
- Prepare the documents necessary to respond to the dispute and submit to the credit card company for disposition
- Communicate directly with credit card vendors via phone and/or email to resolve complex issues correlated with the credit card disputes
- Access and work across multiple billing and vendor related systems
- Work with other various internal teams; such as, Fraud, Billing Operations, Customer Care and Accounts Payable to resolve the credit card disputes
- Identify chargeback process improvement opportunities
- Perform other duties as required/ assigned by management
- There are no supervisory responsibilities associated with this job
- Experience with Credit Card & Chargeback Processing is a requirement
- Knowledge of Credit Card Vendors (Paymentech, American Express and Discover) Chargeback Online Systems is a plus
- Proficiency with MS Excel
- HS Diploma or GED
- Strong emphasis on attention to detail and accuracy of work
- Demonstrates professionalism and maintains confidentiality with regard to customer information
- Interpersonal skills and ability to interact and work with staff at all levels
- Ability to pay attention to details and be organized
- Ability to project professionalism over the phone and in person
- Willingness to take initiative
- Spelling, grammar, proofreading and editing skills
- Excellent time management skills, with the ability to prioritize and multi-task, and work under shifting deadlines in a fast-paced environment
- Must have legal right to work in the U.S
- Basic knowledge of MS-Office Suite (emphasis on Word and Excel)
21
Senior Provider Service Representative Resume Examples & Samples
- Maintains strong relationships with internal departments to support customer implementation activities and provider network needs. Responsibilities to include, but not limited to, all procedures related to new PPO business implementation requirements for new and existing customers, PPO termination procedures and all other network related activities
- Supports customers and internal units to implement new, expanded and/or existing provider network and/or PBM relationships. Involved in day to day troubleshooting on PPO issues and maintains an active and positive relationship with our PPO partners
- Develops, maintains, reviews and distributes internal communications, to include but not limited to, significant changes involving a provider network, newsletter preparation and distribution, employee notifications for ID card changes and processing for PBM Work Orders for existing customers
- Facilitates the resolution of provider network issues affecting internal and external customers. Addresses network issues with customers. Identifies and recommends solutions. Works closely with the Provider Network Operations
- Responsible for provider network renewal analysis to optimize our network relationships for existing customers on renewal or upon request. Ability to provide follow up and track the success of recommendations. Ability to request, prepare and review a variety of network analysis based on discount and provider access
- Reviews and facilitates provider network approval of ID cards for network accuracy and completeness
- Provides customer service by answering provider network questions, resolving elevated claim issues (prompt pay, balance billing, etc.) and attending customer meetings as required. May be required to coordinate claim issues involving Provider Network Operations
- Maintains and/or monitors the provider nomination process
- Prepares a variety of reports involving network activities
- Monitors discount guarantees for the customers and network performance guarantees for the PPOs. Orders PPO directories, if necessary
- Understands and supports the Rules of the Road for all PPO networks including Options and Choice Plus
- Ability to process and monitor the exception requests for network quilting, benefit plans and Choice Plus exceptions
- Maintains and supports work-flow, adapting to changing needs of the organization, by effectively communicating with internal and external areas
- The above duties require a clear understanding of multiple claim platforms. The Network Specialist is expected to be the subject matter expert regarding all PPO networks
- Contributes to a team effort by performing other duties as may be assigned
- Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement
- 4+ years of Managed Care or Medical Insurance experience
- 2+ years of experience in a Claims, Customer Service or Provider Support role
- Intermediate level of proficiency with MS programs including Excel and Word
- Intermediate level of Research and Analytical Skills
- Experience in a role requiring the ability to work independently and remain on task
- Experience in a role requiring good organization and planning skills
- Experience in a role requiring strong interpersonal and oral communication skills including telephone etiquette
22
Senior Loan Representative Resume Examples & Samples
- Determine the wants, needs and interests of each customer to help drive loan listing conversion
- Provide a positive, professional, empathetic, consultative, sales-focused experience exhibiting the Lending Club brand
- Address the customers objections, provide solutions and position the appropriate Lending Club opportunity to achieve their goal
- Follow assigned scheduling guidelines to meet demand for business needs
- Help create a world class sales experience and thrive in a competitive environment
- Answer inbound customer calls a minimum of 60-80% of their time dependent upon non-production assignments
- Demonstrate a mastery of internal reference and resource systems and support/advocate the use of the reference materials by loan representatives
- Support supervisors by backing up leadership as a floor walker to assist representatives in troubleshooting and call escalations
- Participate in other tasks/projects in conjunction with Operations and interdepartmental partners
- Participate in training opportunities to develop leadership/management skills
- Conduct 1:1s as needed
- Conduct side-by-sides as part of ongoing team development
23
Senior Biopharmaceutical Representative Resume Examples & Samples
- Expert local knowledge in the primary care or specialty market
- Successful launch experience in a highly competitive market
- Outstanding business acumen including experience with: Medicare Part B Contracting Managed Care or pull-through Capital equipment or durable medical device sales
- Proven strategic account management
24
Senior Biopharmaceutical Representative Resume Examples & Samples
- Master's Degree OR Bachelor's Degree & 2 years of Sales experience OR
- Associate's degree & 6 years of Sales experience OR
- High school diploma/GED & 8 years of Sales experience
- Core Competencies: Planning and Organizing Work, Engaging Others through Effective Communication,
- Drive to Achieve, Individual Leadership and Impact
25
Senior Biopharmaceutical Representative Resume Examples & Samples
- Collaborates with managerto develop and implement territory POA and key account plans
- Contributes toCluster/Territory Teams Collaborates (Medical Affairs/Key Account Manager, etc.) to agree on key account plan objectives/responsibilities
- Engages with peers and Sales Manager to learn and share best practices
- Demonstrates an understandingof industry and healthcare trends, of how retail practices, clinics and hospitals operate
- Follows throughon customer commitments and requests in a timely fashion
- Reports customer activity and ensures customer profiles are kept up-to-date
- Demonstrates an understanding of selling skills to satisfy customer and Amgen needs
- Seeks adviseand assistance to organize activities
- Accountable for the management of the allocated territory, including successful implementation of all approved activities
- Financial authority limit of R500, thereafter expenses to be approved by National Field Sales Manager (although authority limit of R500 exists, all monies to be spent must be communicated with the NFSM prior to committing to the spend)
- Fully accountable for the adherence to Code of Conduct in carrying out every aspect of your job function
- Accountable for the safekeeping and maintenance of assigned company property
- Provide impeccable customer service and remain professional, courteous and act with due urgency on customer requests
- Professional Sales Representatives to uphold the principle of conducting business with honesty and integrity
- Demonstrates an understanding of the sales cycles, hospital environment & industry environment and applies this knowledge in day to day practice
- Awareness of Amgen/competitor product s and services
- Problem-Solving
26
Senior Dispute Representative Resume Examples & Samples
- When chargebacks are challenged by the opposing party via a representment, collaborate with senior staff to review the new evidence to assess its validity and either resolve the claim or counter-challenge the representment through Visa's pre-arbitration, pre-compliance, arbitration, or compliance process
- 3+ years' experience working in banking or a merchant acquiring, card issuing, or back office banking environment
- A fundamental knowledge of Visa's International Operating Regulations, industry trends, and industry best practices
- The ability to occasionally work off hours to support the global team
27
Senior Biopharmaceutical Representative Resume Examples & Samples
- 2+ years of specialty sales experience in Osteoporosis and/or Cardiovascular
- Experience working with Cardiologist, Endocrinologists, Specialty Pharmacies and/or Biologics
- Associate and/or Bachelor completed degree
- Local market access knowledge
- Computer proficiency (Word, PowerPoint, Excel)
- Excellent communication skills in English and Spanish
- Flexibility to work extended hours including weekends
- Proven sales track record (special recognitions, awards, others)
28
Senior Provider Service Representative Resume Examples & Samples
- 2+ years experience in a claims, customer service, prior authorization, eligibility, benefits or provider support role
- Proficiency with MS Excel, Word and Outlook - ability to create documents or spreadsheets, save and send documents, filter emails and utilize calendar
- Knowledge of NV based insurance markets, Medicaid knowledge highly preferred
- Macess and/or Facets experience
29
Senior Provider Service Representative Resume Examples & Samples
- High school diploma/GED
- 4+ years of managed care or medical insurance experience
- 2+ years’ experience in a claims, customer service or provider support role
- Experience with research and analysis
- Intermediate level of proficiency with MS programs, Excel and Word
- UNET or NDB experience
- Hospital/Physician Office experience
30
Senior Provider Service Representative Resume Examples & Samples
- 2+ years of experience in a claims, customer service or provider support role
- Intermediate level of proficiency with Microsoft Excel and Word
- Available to work Monday through Friday from 8:00 am - 5:00 pm (flexible on start and end times)
31
Senior Provider Service Representative Resume Examples & Samples
- Must be flexible to work any shift needed based on company needs
- 6+ months of Managed Care or Medical Insurance experience
- Dental office experience
- SharePoint experience
- Comfortable working within a team environment as well as independently
32
Representative, Senior Land Resume Examples & Samples
- Negotiating rights of way and easements with landowners, tenants, municipalities, and attorneys
- Investigating landowner complaints and damage claims, and negotiating damage settlements
- Drafting legal agreements; researching property values; coordinating right of way clearing activities; attending public hearings
- Advising company representatives and interpreting land rights related to company real property assets
- Conducting and reviewing title searches to determine land ownership
- Identifying and securing permits from private, local, state and federal authorities
- Investigating preliminary pipeline routes and securing permission/notifications for new construction surveys, and other operating and maintenance functions
- Coordinating activities of contract land agents when required to support Operations and Engineering projects
- An Associates' degree and/or 5 years' experience in the land and right of way profession
- 5 years' experience in negotiations of real property transactions including easement acquisitions, fee property purchases and landowner damage settlements
- 5 years' experience with real property legal agreements such as leases, easements, deeds, and other legal instruments
- Sixty percent (60%) travel; Fifteen percent (15%) overnight stays
- Demonstrated strong negotiation skills and understanding of process with third parties to include landowners, tenants, attorneys, permitting authorities, and internal customers
- Proficiency with MS Office suite to include Excel and Word
- Proficiency with Land databases and SharePoint is a preferred
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Representative, Senior Land Resume Examples & Samples
- An Associates degree and/or 5 year's experience in the land and right of way profession
- 5 years experience in negotiations of real property transactions including easement acquisitions, fee property purchases and landowner damage settlements
- 5 years experience with real property legal agreements such as leases, easements, deeds, and other legal instruments
- Sixty percent (60%) travel required; Twenty percent (20%) overnight stays
- Demonstrated strong negotiation skills and understanding of process with third parties to include landowners, tenants, attorney's, permitting authorities, and internal customers
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Hrsc Representative, Senior Resume Examples & Samples
- Responsible for data entry into the company HR information systems; such as Taleo, EV5, and E-Time
- Answers basic Apria policy and procedure questions such as
- Four-year college degree
- 0-2 years of related experience as a Human Resources professional
- Demonstrated knowledge of HR compensation practices, policies and procedures
- Microsoft Outlook
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Services Representative Senior Resume Examples & Samples
- Completes tasks based on assigned team queues to ensure claims management policies and procedures are followed to assure compliance with service standards, state statutes/regulation, plan documents, and industry best practices
- Provides claims services via internal channels (phone/fax/email/mail/) to claimants and internal and external customers
- Reviews medical-only claims and determines compensability
- Ensures claim files are properly documented
- Completes assigned state filings and error correction timely and accurately
- Coordinates vendor referrals for additional investigation and/or litigation management
- Knowledge of appropriate insurance principles and laws
- Superior customer service skills
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Senior Appeals Representative Resume Examples & Samples
- Positions in this function are responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances
- Communicates with appropriate parties regarding appeals and grievance issues, implications and decisions
- Analyzes and identifies trends for all appeals and grievances
- May research and resolve written Department of Insurance complaints and complex or multi-issue provider complaints submitted by consumers and physicians / providers
- 2+ years of experience analyzing and solving appeals / claims / grievances in an office environment
- Experience in using Microsoft Excel to create spreadsheets and reports
- Experience in working in a dynamic office setting using multiple computer systems as the primary instrument to perform job duties
- Ability to work on weekends if needed
- 2+ years of experience analyzing and solving hospitals or physician claims in an office environment
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Account Representative Senior Resume Examples & Samples
- Ability to work multiple payers
- Demonstrate knowledge of the current functionality of the patient accounting systems
- Evaluate and recommend referrals to agency, law firm, Financial Assistance and Bad Debt
- Identify issues and submit corrective action recommendations
- Identify root cause issues and demonstrate the ability to recommend corrective action steps to eliminate future occurrences of denials. Assist in claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies and procedures
- Initiate appeals/fee reviews as needed
- Managed assigned book of business by ensuring the timeliness and accuracy of billing, collections, contractual postings, payments and adjustments of accounts based upon their functional area standards
- Meet quality assurance benchmark standards and maintain productivity levels as defined by management
- Perform duties and job responsibilities in a fashion which coincides with the service management philosophy of UPMC Health System, including the demonstration of The Basics of Service Excellence towards patients, visitors, staff, peers, physicians and other departments within the organization
- Performs account maintenance including write-off denials and valid contractual adjustments
- Review and take appropriate action on all correspondence related to workers' compensation claims
- Understand third party billing and collection guidelines
- Verify accuracy of payment posting and reimbursement. Work with appropriate payer and/or department to resolve any payment discrepancies
- Works with third party payrors to resolve unpaid claims
- Must have one year of claims, billing, collections experience; OR four years of experience in a business office setting; OR a Bachelor's Degree; OR an equivalent combination of education and experience
- Prior medical billing experience or education is strongly preferred
- Excellent interpersonal, organizational, communication and effective problem solving skills are necessary
- Must be able to communicate with patients, payers, outside agencies, and general public through telephone, electronic and written correspondence
- Prior working experience on personal computers, electronic calculators and office equipment is needed
- Must be multi-disciplined in billing, collections, denials, credit balances and/or the various payers
- Prior collections or medical billing experience with basic understanding of ICD9, CPT4, HCPCS, and medical terminology is preferred
- Familiarity with third party payer guidelines and reimbursement practices and available financial resources for payment of balances due is beneficial
- This position requires organization and time management skills
- The incumbent must develop and manage relationships with colleagues in a professional, independent manner
- The position requires the ability to maintain confidentiality with regard to all assignments
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Senior Appeals Representative Resume Examples & Samples
- 1+ years of experience analyzing and solving appeals and grievances
- 1+ years of computer experience working with PC and Window applications including the ability to learn new programs - Word (ability to create / edit document); PowerPoint (ability to create and send presentations); Excel (Vlookup and formulas)
- 2+ years of experience analyzing and solving appeals and grievances
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Risk Engineering Representative Senior Resume Examples & Samples
- Provides efficient and effective risk evaluation services through timely and accurate site surveys to identify and evaluate loss exposure, hazards and controls for large risks
- Provides consultative risk improvement services to clients through the analysis and evaluation of existing loss control measures, report preparation, safety consultations, and the development of recommendations and corrective action plans to improve loss potential. Will conduct safety training meetings for clients and staff
- Establishes, directs and coordinates loss control services for local accounts
- Contributes to overall SAMMI Sales Program by identifying potential service opportunities
- Continues to increase and broaden knowledge/expertise of the loss control discipline through internal and external training programs. This includes keeping abreast of industry trends, developments, regulatory changes, and state of the art practices to ensure continued effective risk evaluation and consultation
- Provides technical expertise to staff to ensure proper adherence to company policies, procedures and standards
- Performs other duties as assigned by departmental management
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Senior Recovery Representative Resume Examples & Samples
- Responsible for analysis, evaluation, and interpretation of claims facts to determine recovery potential, and consult with adjuster on investigation action plan supporting optimized recovery
- Manage negotiations and settlement with assigned line(s) of business (LOB) and affiliated vendor within given authority amount and follow-up to ensure payments are being made
- Accountable for the analysis of reports for trends and supporting LOB action plan implementation
- Own relationship between vendor and QBE stakeholders, including assigned lines of business (LOB), vendor management and procurement
- Accountable for all vendor assigned claims until settlement or disposition is reached and document all relevant claim activities to ensure efficient and timely processing of recovery claims; Pressure on faster recoveries
- Provide accurate and timely information to all external and internal customer concerning claim status and other claim inquiries
- Responsible for educating agents, insureds, claimants, regional offices, and vendors on the recovery process, in accordance with applicable laws, to improve levels of customer service
- Manage attorney utilization and partner with internal QBE stakeholders on building a recovery panel
- Oversee training efforts (CE based) to improve investigation quality and optimize recovery outcomes
- 5 years relevant experience
- Strong knowledge of claims department processes and procedures
- Strong knowledge of Microsoft Office Suite applications, including Outlook, Word and Excel
- Strong understanding of insurance policy and contract language
- Strong knowledge of claims legal regulations and technical processes
- Provide personalized and quality service to meet the expectations of internal and external customers
- Use inquisitiveness and logical and structured analytical reasoning skills
- Utilize effective research and investigative techniques
- Utilize organizational agility to get things done through both formal and informal channels
- Ability to effectively and independently manage workload while exhibiting good judgment
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Transfer Agancy Shareholder Services Representative Senior Resume Examples & Samples
- Process and validate all inquiries within agreed internal and external Service Level Agreement’s
- Ensure all inquiries are logged into the query management database, follow up inquiries that remain unresolved outside of agreed Service Level Agreement’s and review with the Supervisor or Manager any issues requiring escalation
- Assist the Manager / Team Leader / Supervisor in overseeing the day-to-day activities of the department
- Validate and approve related tasks including but not restricted to client reporting
- Effectively handle special processing situations including exceptions that require strong oversight
- Actively participate and work with the Client Service Managers and Production Support in the launch of any incremental business
- Ensure the preparation of any mailings required for internal or external vendors
- Ensure terms of Funds prospectus are being adhered to at all times
- Keep Errors and Omissions at a strict minimum at all times and ensure deadlines are met
- Ensure that policies and procedures are adhered to on a daily basis and have this proofed and suggest changes or amendments procedures and service standards, as identified
- Complete month end reporting internally and externally
- Remain knowledgeable of changing industry initiatives (attend to presentations, work sessions & personal effort) and educate clients continually through presentations
- Establish solid contacts with all areas and all levels at clients’ organizations as well as inter departmental
- BA/MS degree and/or equivalent work experience
- Minimum of 2-3 years of Transfer Agency experience
- Prior experience working in a client servicing focused work environment
- Attention to detail and proven ability to handle complexity
- Ability to multitask and to manage competing priorities given broad portfolio of clients
- Ability to work effectively under pressure and demonstrate initiative
- Proven ability to adapt to change and problem solving
- Knowledge or prior experience of payments systems and reconciliations systems and or Multifonds is an advantage
- A second language is a plus, preferred is German and / or French
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Hrsc Representative Senior Resume Examples & Samples
- Performing daily Taleo load (loading/auditing/correcting errors) for new hires from Taleo to EV5
- Assists with HRConnect in-box
- Approve and apply HR transactions
- Assisting with inquiries and rerouting of MSS transactions
- On-board new employees
- Prepare employment offer letters
- Order pre-employment background checks and drug tests
- Assisting with Relocation process
- Processing of Employee Referrals (approvals and payments)
- Answer tier 2 level questions
- Accurately answer more complex policy & procedure questions
- Assist with training new hires within the department
- Processes invoices from various vendors and ensures timely payments
- Assists with ADA process
- Performs other related duties as directed by supervisor
- Four year college degree or equivalent experience is required
- At least two years of experience is required
- Ability to type 40 words per minute
- Ability to multi-task in a fast paced working environment
- Intermediate level Microsoft Office
- Intermediate level of mathematical proficiency
- Bachelor’s degree in HR/Business Administration is preferred
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Appointment Services Representative Senior Resume Examples & Samples
- Schedule appointments via phone for multiple specialties and locations including providing directions and other information regarding appointments
- Complete full registration cycle including setting up insurance coverage for new patients and verifying coverage for established patients
- Process referral queues, messages, faxes, email, and other correspondence following detailed guidelines and provide information to schedule patient appointments
- Develop understanding of Froedtert & Medical College of Wisconsin clinic locations and affiliates including directions to and within associated buildings
- Take messages, answer questions, and direct calls if customer inquiries are unrelated to scheduling or registration
- Organize reference materials and email volume keeping records and communication updated
- Ensure a positive customer experience by anticipating and diffusing customer challenges
- Assist with quality control measures and special projects including rework, quality review of colleagues, and verifying report accuracy
- Record referral information and work with Utilization Management to facilitate patient care
- Complete MSP questionnaires with Medicare patients
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Senior Appeals Representative Resume Examples & Samples
- Independently reviews the members’ case file to determine if representative / appellant is authorized party and if complaint is valid. These may include: Medical benefits, eligibility, claim payment, deductible limits and co-payments, pharmacy benefits, eligibility and claims, and billing and enrollment inquires
- Demonstrates proficiency in determining if case requires creation of multiple complaint records and reviews correspond to determine classification and sub-type
- Prioritizes workflow on a consistent basis, applies key HIPAA and CMS guidelines in daily workflow, and meets turnaround times for assigned cases
- Research and investigate complex issues through the use of multiple internal computer databases, external computer systems and supporting technology, such as scanning / imaging
- Partners with all service delivery functions ( i.e. clinical, claims, billing and enrollment) to answer member questions / or works with others to resolve escalated issues
- Develops and delivers timely and professional communication dealing with complex issues at each step of the process to advise members of the progress and status of their issue. (Quality standards means that all correspondence must be error free - no spelling, punctuation, grammatical or other errors.)
- Maintains system documentation on the tracking and monitoring of all cases as well as the final disposition to ensure overall compliance with Medicare regulations
- Meets established productivity and quality standards in addition to attendance requirements
- Ability to work from Monday to Friday in any shift between 8am-6pm
- 1+ years of customer service experience analyzing customer problems
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Senior Provider Service Representative Resume Examples & Samples
- May coordinate others' activities
- 1+ years of current CSP Facets experience
- 1+ years of Managed Care or Medical Insurance experience (e.g., billing practices, terminology)
- 1+ years of experience in a Claims, Provider Related Customer Service or Provider Support role
- Experience utilizing Microsoft Excel (data sorting and filtering) and Microsoft Word (create documentation)
- Experience analyzing data to determine root cause of issue
- Microsoft Excel (more advanced skills including VLOOKUP)
- Ability to work with Physicians, Ancillary and Facility Claims, including understanding of internal claims and payment policies and procedures
- Ability to work with Physician, Ancillary and Facility Contracting Methodologies (e.g., in-network vs. out-of-network, contracted rates, medical agreement configurator)
- Experience managing multiple tasks within established timelines
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Senior Provider Service Representative Resume Examples & Samples
- Works independently; May act as a resource for others
- Performs routine and moderately complex audits
- Actively coordinates and communicates audit requests until completed
- 2+ years of previous healthcare credentialing experience
- 2+ years of experience in a claims, customer service, or provider support role
- Intermediate (or higher) level of proficiency with Microsoft Word and Microsoft Excel
- Knowledge of CMS
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Senior Provider Service Representative Resume Examples & Samples
- Proficiency within Microsoft Word (Ability to create and edit documents)
- Proficiency within Microsoft Excel (Ability to filter and sort within spreadsheets)
- Previous experience in a corporate setting
- Previous experience working for Managed Care or Medical Insurance industry
- SalesForce experience
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Account Representative Senior Resume Examples & Samples
- Initiates appeals/fee reviews as needed
- Understand third party billing and collection guidelines. Ability to work with multiple payers
- Works with third party payors to resolve unpaid claims
- Must have one year of claims, billing, or collections experience; OR four years in a business office setting; OR a Bachelor's Degree; OR an equivalent combination of education and experience
- Prior medical billing experience or education is preferred
- Prior patient access experience is preferred
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Account Representative Senior Resume Examples & Samples
- Understand third party billing and collection guidelines. Ability to work with multiple payors
- Previous experience with ambulance billing is preferred
- Previous AR follow-up experience is preferred
- A strong background in medical terminology is preferred
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Site Service Representative Senior Resume Examples & Samples
- Identifying and implementing processes to manage the customers' repairable parts program
- Providing on-site customer service to meet the needs of the customers and other internal departments
- Identifying and developing opportunities to grow and expand ATS service with the customer
- Expediting and following up on orders with both internal and external suppliers
- Scheduling, dispatching, and tracking repair activity from inception to close on scheduling software
- Tracking repair cost and savings
- Tracking and capturing of warranty claims
- Basic sales and persuasion skills
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Representative Senior Resume Examples & Samples
- Assure distributors will promote brand properly to existing customers and continually seek and close new customers. Both these functions should lead to a desired product mix and market share
- Work with top management of distributor businesses to identify and capitalize on areas of
- Formal education such as Bachelor’s degree is preferred but not a requirement
- Technical and hands-on knowledge and 3+ years of experience with agricultural drip irrigation systems, including operation, application, troubleshooting and maintenance are required
- At least 2-3 years of practical experience in sales
- Experience with our product is a plus
- Excellent oral/written communication skills and reading comprehension
- Ability to adapt to a dynamic and changing work environment and work in cross functional teams
- Experience and comfortable in conflict resolution
- Demonstrated history of a high level of attention to detail and customer service
- Proven ability to prioritize, hit multiple, and competing deadlines
- Must be a self-starter, self-motivated, and results oriented
- Good systems aptitude with proficiency in MS Office, solid PC/keyboarding skills, and ability to learn and use ERP, SalesForce, and TMS systems. SAP experience preferred
- Strong basic math skills
