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Professional Summary

Committed to both internal and external customer satisfaction: hard work and accountability: strive to always improve my skills and go above and beyond for the success of the team. Looking to obtain a challenging position in a professional environment with the philosophy of patient/customer support & complete satisfaction.

Core Strengths
  • Strong medical ethic
  • Computer proficient
  • Customer service expert
  • Leadership skills
  • Complete Non-Clinical Revenue Cycle
  • Strong analytical & organizational skills
  • Healthcare billing proficiency
Professional Experience
02/2018 - Current Lead Precertification Specialist Trustees Of The University Of Pennsylvania | Philadelphia, PA
  • Report directly to the Manager / Supervisor of the Financial Clearance department.
  • The first point of contact for the Precert Specialists staff, workflow, and system issues.
  • Assists in the development and implementation of appropriate policies, training, and workflows.
  • Subject matter expert for insurance verification, benefit and precertification obtainment for all HUP scheduled outpatient surgical procedures and inpatient admissions via telephone and online tools.
  • Call insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Verify that patients have the proper insurance coverage prior to any procedures.
  • Follow specific security rules and guidelines to protect sensitive data, including patient medical records and payment card information.
  • Retain strong medical terminology understanding in an effort to better comprehend procedures.
10/2017 - 02/2018 Patient Service Representative Delancey Internal Medicine Rittenhouse | Philadelphia, PA
  • A primary point of contact for patients and providers.
  • Greet, check-in & check outpatients.
  • Scheduled and confirmed patient appointments with patients and healthcare professionals.
  • Explained eligibility details and affordability options to patients with kindness and respect.
  • Collect co-pays, answer phones, schedule appointments.
  • Obtain referrals and pre-certifications.
  • Complete daily cash collection deposit.
  • Train staff on front desk policies and procedures.
08/2015 - 08/2017 Collections Specialist II DaVita Healthcare Partners | DeLand, FL
  • Research, appeal, resolve claim rejections, underpayment and denials.
  • Initiate collection follow-up of all unpaid or denied claims.
  • Analyze contracts between DaVita and insurance companies to ensure proper billing and payment.
  • Respond to written insurance communications as indicated with appropriate action in a timely manner.
  • Document all follow up and communication in the patient's account.
  • Verify details of transactions, including funds received and total account balances.
  • Complete weekly/monthly AR variance reports, improving workflow process.
  • Review outstanding balances and identify accounts in need of collection processing.
  • Advised process improvements to secure prompt and regular receipts for the organization.
  • Meet/Exceed monthly and quarterly goals.
  • Maintain audit accuracy rate of 98% & above.
  • Provide onsite training on BC/BS policies and collection process.



08/2014 - 07/2015 Patient Intake Specialist DaVita Healthcare Partners, INC | Deland, FL
  • Verify benefits & eligibility for outpatient kidney dialysis laboratory testing.
  • Update all billing systems & associated systems with patient demographics & insurance accurately and timely.
  • Maintain audit accuracy rate of 96% and above.
  • Rank in the top 3% of high performing teammates monthly.
  • Improved operations by working with team members to find workable solutions.
02/2011 - 06/2014 Financial Services Representative Hospital of the University of Pennsylvania | Philadelphia, PA
  • Verify benefits & eligibility for scheduled, direct admit, transfer & emergency room admissions.
  • Update demographics in EPIC, and SMS registration systems.
  • Document account status in Ontrac
  • Contact patient or financially responsible member to discuss their financial obligation
  • Complete financial assessments with non-insured patients being transferred for admission from outside hospital
  • Initiate contact with insurance carriers within 24 hours of admission & obtain pre-certification.
  • Collect co-pays, deductible, and self-pay patient payments.
  • Post patient payments, and reconcile accounts for hospital & clinical practices for bank deposit.
  • Maintained an accuracy rate of 97% and higher.
02/2003 - 01/2011 Billing Coordinator- Heart & Vascular Laboratory Hospital of the University of Pennsylvania | Philadelphia, PA
  • Batch and verify all required elements such as ICD-9, CPT-4 codes, referrals and pre-certification for charge entry.
  • Charge entry and code correction for completed Echo & Stress test.
  • Increase revenue by decreasing rejections with new billing procedures.
  • Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
  • Accurately reconciled patient payments for account posting.
  • Managed daily operations for the billing department staff.
  • Meet monthly and year-end closing accounts reconciliation.
Community Service
  • Freedom Playground restoration project-2015
  • United Methodist Church- Feed the homeless program -2015
  • Camp Boggy Creek restoration project -2016
  • Give Kids the World fundraiser -2016
  • Journey's End animal sanctuary clean-up project-2017


Certifications

AAHAM-Certified Revenue Cycle Specialist- Institution

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Skill Highlights
  • Impeccable business acumen and prioritization skills for strong Portfolio Management
  • Superior problem-solving and analytic skills leading to process improvement and cost reduction.
  • Leads complex operational and strategic initiatives across global geographies
  • Expertise in developing business processes and metrics to measure them
  • Agile and Waterfall methodologies
Accomplishments
  • Lead of Project Management Office (PMO) and Portfolio Management framework
  • Directed establishment of agency-wide virtual call center (VCC) and National Service Delivery Team (NSDT) for Financial administration and Human Resources
  • Global Program manager at Intel Corporation, managing staff that included Project Managers, developers, Quality Assurance and contractors
  • Oversee capital purchase budget greater than $15 million dollars
  • Coordinated staffing and planning activities to support the security of all IT systems for 60 sites worldwide
  • Led implementation of ITIL Service Level Management project team consisted of 30 analysts and developers. Standardized over 60 business processes and services from Finance, Human Resources (HR) and Information Technology (IT) organizations
  • PMI-PMP, FAC P/PM Level III, and ITIL Certifications
  • Recipient of the National Earth Team Individual volunteer Award- Facilitated Agricultural Water Enhancement Program (AWEP) project proposal that was awarded over $1.3 million in funding
Experience
PMO- IT Specialist, 03/2011 to Current US Department of Agriculture-NRCS Portland, OR
  • Led deployment ofMicrosoft Project Server and Project Online resulting in Improved ResourceUtilization and improved Earned Value Management; on-time and on-budgetprojects for the entire NRCS Portfolio
  • Designedconfiguration and deployment of MS PowerBI Portfolio dashboard. Suite of twelveunique dashboards for a portfolio of 13 Investments containing more than fiftyunique projects. Dashboards provided foraccess, extraction and presentation of data for the purpose of businessintelligence analysis
  • Created Requirements Management Plan for Enterprise Architecture team by designing new Requirements process and implementation of IBM Rational Requirements Composer
  • Developed and implemented Program Management Office (PMO) to transform IT project management (PM) structure to a centrally managed and streamlined support organization. Provide policy, planning and project data insight to senior management for their use in ranking key operational and budgeting decisions


Program / Project Manager (PM), 03/2000 to 07/2008 Intel Hillsboro, OR
  • Developed Business Intelligence (BI) strategy and established project scope to evaluate overall health of IT Operations and HR environments through standardized measurement practices. Output of BI project utilized by different across IT and HR business groups, all global geographical regions, up to the Vice-President level
  • Implemented ITIL Service Level Management Problem Management process by deploying BMC Remedy Service Desk software. Led project team consisting of 30 analysts and developers for standardization of Service Level Management process and represented more than 60 services from Human Resources (HR) and Information Technology (IT) organizations
  • Global Program Manager for team of six Project Managers responsible for the migration of 60 sites, 5,000 nodes, 150 automated-tape library units and over a petabyte of data. PM for deployment of Enterprise Backup and Restore server. Designed disaster recovery project plan, training, and drill scenarios for delivery to all sites worldwide. Established baseline budget and completed ROI analysis
  • Managed a budget of over $11 million dollars, including purchase justification for hardware and software design, licenses, and maintenance
  • Gathered business requirements, prioritized needs, and built use-cases for projects. Collaborated in the planning, design, development, selection and deployment of new software implementation. Defined project success criteria and facilitated the process of generating, documenting and implementing As-Is and To-Be business process workflows
  • Effectively managed project stakeholders' expectations by coordinating communication plans, defining project success criteria and disseminated project progress documentation to involved parties throughout project life cycle for multiple, simultaneous projects
 ​
Education
BA: Philosophy Loyola University of Chicago Chicago, Illinois, US

Minors - English, Business Administration

Certifications

Project Management Institute - PMP

FAC P/PM, Federal Acquisition Certification for Program/Project Managers -Lvl III

Information Technology Infrastructure Library (ITIL) Practitioner - IT Service Level Management Certification Foundation Certification

COR Level 1 - Federal Procurement

Software

ARIS, BMC Remedy v7, Cisco Jabber VTC, IBM Rational, ERIS GIS, JIRA,

Microsoft Project Server, MS Office 365, MS Power BI, MS Sharepoint, Mindjet MindManager, Metastorm Provision, Pentaho Kettle 4.0, Tableau Desktop v5.0, SAP Business Objects Desktop Intelligence, Salesforce, and VidYODesktop

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Summary

Ability to work with varying amounts of service related inquiries and perform needed research for resolution. Self-motivator who applies individual initiative to complete the job responsibilities. Experience working in a Software and/or service company environment. Experience working in a call center environment. Experience working with a Human Resources and/or benefits administration software. Over 5 years Customer service work experience Payroll, Benefits, and Human Resources knowledge. Experience in working with clients in a fast paced, complex, deadline oriented service environment

Skills
  • MS Office applications (Word and Excel)
  • Strong organizational Skills
  • Excellent Communication skills-verbal, written and digital(email,chat,text)
  • Problem resolution
  • Spreadsheet development
  • Insurance processing
  • Health insurance processing
  • Insurance eligibility verification
  • ICD-9
  • CPT Coding
  • Epic
  • Ability to Multi-task
  • Employee Relations
  • Exceptional telephone etiquette
  • Claims appeal procedures
  • Report Analysis
  • Medical Terminology
  • Medical Billing
Work History
Medical Billing /Referral Coordinator, 03/2019 to Current
Lamar Medical Center Augusta, Georgia
  • Precisely evaluated and verified benefits and eligibility
  • Advance knowledge of appointment scheduling and insurance/prior authorization guidelines
  • Responsible for entering and tracking all internal and external referrals using EPIC referral tracking module
  • Demonstrates knowledge of basic computer programs and electronic medical record navigation skills
  • Evaluated patients' financial status and established appropriate payment plans
  • Advanced problem-solving and analytical skills
  • Flexibility and ability to work in , and stressful situations
  • Demonstrates level of interpersonal skills necessary to effectively communicate with patients, staff and physicians' personnel with whom daily interactions must take place
Medical Billing And Collections Specialist, 08/2016 to 04/2018
Pediatric Partners of Augusta Augusta, GA
  • Utilized ALLSCRIPTS to manage and confirm patient data, such as insurance, demographic and medical history information
  • Communicated effectively with staff, patients and insurance companies by email and telephone
  • Verified patients' eligibility and claims status with insurance agencies
  • Responded to correspondence from insurance companies
  • Evaluated patients' financial status and established appropriate payment plans
  • Determined prior authorizations for medication and outpatient procedures
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls to ensure proper payments were made according to contracts
  • Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment
Employee Support and Resolution Representative, 05/2012 to 10/2014
ADP Augusta, GA
  • Provide accurate timely resolution to over 50 inbound telephone calls
  • Used multiple tools and resources to develop an accurate and comprehensive response to inquires
  • Interface and collaborate with third party vendors to find resolution Research, investigate, analyze and resolve issues of varying complexity Support a seamless interaction with Positive Defining Moments for the employees of various clients
  • Assisted less experienced representatives with handling complex employee inquiries
  • Documented calls and issues in case management tool
  • Made outbound calls to employees as applicable, to provide timely and accurate resolution
  • Provided support through use of an internal knowledge base tool and applicable Human Resource, Benefits and Payroll systems Participation in the development and documentation of processes and procedures, appropriate escalation of technology issues, feedback to improve training programs, and escalating client feedback
  • Ability to consistently follow processes and procedures Proficiency in using a PC and Microsoft applications
Benefits Representative, 09/2011 to 05/2012
ADP Augusta, GA
  • Served as a member of an Administrative Service Center Team
  • Respond telephone calls, emails, and facsimilies that are sent to the Benefits Call Center for all customer supported by the Service Team
  • Worked closely with a clients Human Resource staff and employees respond to benefit related inquiries and questions
  • Worked closely with a client's benefits provider(s) to resolve eligibility issues and to escalate service and/or claims issues on behalf of employees
  • Establish and maintain effective relationships with clients and gain their trust and respect
  • Provide tier one support to HR/BAS clients and their employees who contact the service center
  • Communicate benefit changes and policy as necessary
  • Research and resolve complex employee benefit problems and questions
  • Perform all Quality Assurance (QA) procedures as specified in the client's Administrative Procedures document
Education
Medical Billing And Coding Miller Motte Technical College - Augusta GA
Certificate Medical Coding and Billing : Continuing Education: 2003
Augusta State University - Augusta, GA
Diploma: Cosmetology, 1998
Cosmetology
High School Diploma: 1995
Augusta Technical College - Augusta, GA
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Professional Summary

Detail-oriented aircraft mechanic trained in directing, trouble shooting, monitoring or performing preventive and unscheduled maintenance on aircrafts. Through the Air Force I was schooled in turboprop and turboshaft engines but work with the T-56 on the C-130. Thorough knowledge of standard industry hardware and materials with a continuous drive for new knowledge.

Skills
  • Strong Algebra and general math skills
  • Hourly shift management
  • Personnel development
  • Customer-oriented
  • POS systems
  • Merchandising
  • Bank deposit procedures
  • Detail-oriented
  • Strategic thinker
  • Staff training and development
  • Opening and closing procedures
  • Goal-oriented
  • Customer relations
  • Effective leader
  • Efficient multi-tasker
  • Employee scheduling
  • Conflict resolution
  • Organized
  • Strong communication skills
  • Superior attention to detail
  • Knowledge of aircraft hardware and materials and processes.
  • Deicing of aircraft
  • Military maintenance requirements
  • Crew coordination
  • Quality assurance
Work History
Engine Specialist 04/2017 to Current
United States Air Force Reserve Command Marietta, GA
  • Went to technical school for Aerospace Propulsion in the United States Air Force where I learned tool knowledge, turboprop and turboshaft engines, and also hazmat training.
  • Performed scheduled and unscheduled inspections to check flight readiness of aircraft.
  • Monitored parts department and placed orders for maintenance supplies on a consistent basis.
  • Assisted with aircraft and equipment transport and movement.
  • Removed and installed aircraft subsystem assemblies such as engines, rotors, gearboxes, transmissions and mechanical flight controls.
  • Complete all paperwork requirements for each task, including recording maintenance actions in aircraft logbooks.
  • Oversaw inventory, equipment maintenance and bay cleaning.
  • Performed routine preventive maintenance to ensure that building systems operated efficiently.
  • Supported technicians in equipment maintenance and repair.
  • Lubricated shafts, bearings and gears to maintain optimal performance.
  • Diagnosed faults and developed resolution plans.
  • Maintained an orderly and safe work environment by enforcing tool control and FOD awareness, prevention and safety at all times.
  • Conducted and oversaw safety protocols, including flight line foreign object prevention walks.
  • Aided crews in joining, wrapping and sealing sections of pipe.
  • Promoted shop safety by working in a safe manner.
Store Manager 06/2013 to 04/2018
Southfitters Albany, GA
  • Interviewed job candidates and made staffing decisions.
  • Counted cash drawers and made bank deposits.
  • Managed staff of 8 sales associates, and 2 assistant managers.
  • Assigned employees to specific duties to best meet the needs of the store.
  • Reordered inventory when it dropped below predetermined levels.
  • Instructed staff on appropriately handling difficult and complicated sales. Hired, trained and evaluated personnel in sales and marketing.
  • Examined merchandise to verify that it was correctly priced and displayed.
  • Planned budgets and authorized payments and merchandise returns.
  • Trained and developed new associates on POS system and key sales tactics.
  • Generated repeat business through exceptional customer service.
  • Conducted store inventories once per quarter.
Education
High School Diploma 2011 Southland Academy - Americus, GA
Associate of Science: Focused on Biology 2013 Darton State College - Albany Georgia
Additional Information
Security clearance and obtain a CAC ID card