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yyyyyy x. yyyyyy                                                    0000 xxxxxx xxxx , xxxx , xxxxx 00000

                                                                                                                                                  xxx-xxx-xxxx

                                                                                                                                               abc@xyz.com

 

objective

exploring career opportunities to utilize advanced education, auditing, staff management, training, operational support and communications abilities in a challenging healthcare insurance claims auditor role.

 

career profile

ø  master of science and bachelor of science degrees in business administration.

ø  over ten years of comprehensive medical insurance processing and adjudicating.

ø  strength in processing, analyzing and evaluating insurance claims and coding.

ø  proven background in all facets of auditing operations and management.

ø  outstanding skills in direction of financial and business procedures.

ø  skilled in administrative leadership, staff training, presentations and documentation.

ø  exceptional communications and interpersonal abilities.

ø  well-organized multi-tasker with strong detail orientation.

ø  results-oriented with emphasis on obtaining full utilization of resources to achieve organizational goals and objectives.

ø  skilled in advanced medical and laboratory software and equipment.

 

 

technology skills

ms office suite, great plains, visio, cms desktop pricer, ingenix webstrat pricer, emed medisource pricer, eci, beechstreet, phcs, multiplan, power mhs

 

 

healthcare auditing experience

independent health, williamsville, ny                                                                                               2001 - 2009

internal auditor associate (2007-2009)

       performed claims and operation audits and presented issues to claims quality team for review.

       documented high-dollar claims process and developed value-added recommendations to reduce risk.

       represented internal audit on claims quality, claims operation and corporate compliance teams.

 

claims adjudicator specialist (2001-2007)

       processed and adjudicated medical and dental claims and adjusted non-participating provider claims.

       priced claims with dedicated software, entered administrative authorizations and assisted representatives.

       improved claims training process, trained supervisors and assisted with updates and policy creation.

       tested hold code and policy implementation, resolved processing issues and served on qa subcommittee.

 

north american health plans, amherst, ny                                                                                       1999 - 2001

hcra medical claims analyst

       processed and adjudicated medical, dental and cob claims.

       researched problem claims for benefits, liability, overpayment and coding errors.

       assisted member service representatives with calls.

 

 


yyyyyy x. yyyyyy

page two

 

 

 

 

education

university of phoenix, phoenix, az

master of science, business administration, 2010

bachelor of science, business administration, 2008

 

 

 

other career background


fortistar greenhouse, north tonawanda, ny                                                                                2009 - present

packhouse supervisor

       interview and hire employee candidates, assist production planning and track daily inventory levels.

       supervise work force of 12 employees, lead team safety training for food and bloodborne pathogens.

       prepare documents for safety grant proposal and reconfigured staging area to improve efficiency. 

       coordinate product shipments.

 

additionally, served memories in wood as a part-time sales clerk assisting customers, merchandising store displays and providing customer service, and key bank as a customer service representative, managing large call volume and coordinating with customers, management and bank departments to solve problems.

 

 

 

professional affiliations


member, wildermuth foundation board of trustees

member, board of north cheektowaga amateur athletic association

member, institute of internal auditors

member, buffalo niagara partnership bn360 program

 

 

 

 

 

 

 

 

 


yyyyyy x. yyyyyy                                                    0000 xxxxxx xxxx , xxxx , xxxxx 00000

                                                                                                                                                  xxx-xxx-xxxx

                                                                                                                                               abc@xyz.com

 

 

cover letter text

 

date

 

 

 

hiring agent name

title

company name

address

city, state   zip code

 

dear                   :

 

i am currently seeking a challenging career opportunity in a healthcare insurance claims auditor capacity and am submitting my resume for your review.  in advance, i thank you for your time and consideration.

 

as demonstrated in the accompanying resume, my professional qualifications include a master s degree in business administration and over 10 years of medical and dental insurance claims processing, auditing, adjudicating, review and evaluation experience. to complement this background, i possess staff management, training, analytical and problem-solving capabilities. as an employee, you will find me to be an enthusiastic and disciplined team player, committed to supporting you in achieving your objectives through superior performance. 

 

i am confident that i could be a valuable asset to your firm, and look forward to interviewing with you in the near future to further discuss my areas of experience and expertise that would be a contribution to your organization.

 

 

 

 

sincerely,

 

 

 

yyyyyy x. yyyyyy

 

 

 

 

 

attachment

 

 

 

 

 

 

 

 

yyyyyy x. yyyyyy                                                    0000 xxxxxx xxxx , xxxx , xxxxx 00000

                                                                                                                                                  xxx-xxx-xxxx

                                                                                                                                               abc@xyz.com

 

 

thank you letter text

 

 

date

 

contact name

company name

address

city/state/zip code

 

dear _______________________________:

 

i would like to thank you for providing me the opportunity to interview with you and discuss the exciting healthcare insurance claims auditor position currently available with your organization.  having gained a deeper insight into the job requirements and your objectives, i am confident you will find me a valuable asset in achieving your goals.

                                                         

as discussed, i am an enthusiastic, disciplined team player eager to continue a successful career as a dedicated member of your staff.  i believe you will find my dynamic management, coordination and communications skills vital to your operations and look forward to contributing to your success.

 

should you have any additional questions, or to discuss future employment opportunities, please feel free to contact me at your earliest convenience.  again, thank you for the enlightening interview.  i look forward to your response.

 

 

 

 

sincerely,

 

 

yyyyyy x. yyyyyy

 

 

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