From: route@monster.com
Sent: Thursday, September 10, 2015 3:47 PM
To: hg@apeironinc.com
Subject: Please review this candidate for: osp
This resume has been forwarded to
you at the request of Monster User xapeix03
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9830 Concord Ct. Highlands Ranch, CO
80130 720-341-7465 Email hughes00001@yahoo.com Executive
Summary Well-rounded
Executive with broad business capabilities and solid record of
accomplishments in diversified leadership, change management, government
and community relations. strategic planning, operations, sales, marketing,
financial analysis, budget preparation, project management, construction and
technical roles. Extensive experience in leading entrepreneurial
organizations in start up and turn around through a consensus driven
leadership style. My leadership is all about motivating, empowering and
involving supervisors and management in decision making so they engage
with more loyalty and motivation because they feel a sense of
contribution and ownership. -Marketing
and Sales Management Employment
History: 01/2011
– Present Veterans
Health Administration CPD
Department Responsibilities: Voucher Examiner determines the accuracy of the claims
submitted by the providers and the beneficiaries. Authorize medical,
ancillary care and travel for the civilian health and medical programs
provided by the Civilian Health and Medical Program of the Department of
Veterans Affairs (CHAMPVA) beneficiaries. Duties: Verification of claims accuracy submitted to include
mathematical computations, vendors, hospitals, clinic physicians,
laboratories and veteran affairs location information. I am
knowledgeable of the laws, regulations and procedures regarding
entitlement payment for medical, dental, drugs and medicine, prosthetic s,
transportation, durable medical equipment and residential care. I process
approximately 260 claims a day using a 10 key data entry processing,
Microsoft office and HCR Program (VISTA). Training: Claims processing
stems from a six-week course given by the HCR. At the completion of this
course, a certificate of completion was awarded. Processing: When
processing claims, I apply all of the regulations, manuals and policies
governing their correct use for the completion of a claim. The desk
procedures are our method of researching any regulations, manuals, directive
or policies. Missing information includes; vendor information,
diagnostic code (DX), which can be found using the Generic ICD-9-CM using the
proper name of the diagnosis, or the number assigned to the diagnostic code,
they are listed numerically or alphabetically. The information is researched
using the Veterans Health Information Systems and VISTA.. Discrepant
data can be identified in three ways; first there is Discrepant Input, which
is information that does not match the information on the bill. There are
Reopened Claims; these are claims that have been through the process before
and for some reason had to be returned to the provider or the beneficiaries
for some type of missing information which would not allow the claim to be
processed. There are mismatched documents; these are documented images that
have been incorporated into the wrong Document Control Number (DCN). Vendor
information is obtained by accessing VISTA. CHAMPVA benefits are not
paid until the claim has been filed with the primary coverage insurance
and an Explanation of Benefits (EOB) for each insurance company is submitted. |
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Languages: |
Languages |
Proficiency Level |
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English |
Fluent |
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