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Network Support Level Ii Resume

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Objective

A position that would utilize my experience and knowledge in healthcare transactional based services, customer service/sales, and information technology.

Experience

2008-Present Confidential, Asheville, NC
Network Support Level II

  • Support claims processing through Pre and Post editing of all segments of claim from CMS-1500 and pharmacy management software systems.
  • Support Providers with format and policy assistance for Medicare/ Medicaid claim processing services. Intimate knowledge of CMS (state and federal) policy and procedures.
  • Extensive knowledge of ASC X12, 835, 837, and 270/271 eligibility servers. Also up to date with HIPPA 5010 policy changes time tables, and how change will reflect on Providers and CMS claims processing.

2005-2008 Confidential, Asheville, NC
Owner/Operator
Provided logistical services to Fortune 500 companies (Wal-Mart, GM, Ford, Kimberly Clark, etc).

2005 Confidential, Louisville, KY
Vice President of Information Technology

  • Managed a small team network engineers and programmers.
  • Maintained Windows 2000 & 2003 servers LAN, WAN, VPN networks,
  • Developed troubleshooting tracking protocol.
  • Assessed business IT needs and how related to market share.
  • Managed development of programming projects and data management updates.

2003-2004 Confidential, Louisville, KY
Sales/Service

  • Sold Telecomm services to residents and business clients
  • Developed training for Louisville sales staff, increased local sales 30 %.
  • Achieved top salesperson for Louisville, KY office.
  • Received 2003 Pinnacle Club Award for Top Sales Person at Bellsouth

2000-2002 Confidential, Louisville, KY
Network Administrator/Sales Coordinator

  • Supervised purchasing and sales of spares for United States operations.
  • Coordinated sales and purchases with sister company in Europe.
  • Composed technical papers on power industry plant maintenance.
  • Developed database that incorporated the functions of finance, sales, and warehousing - this increased productivity and reduced overhead.

1994-1999 Confidential, Louisville, KY
Technical Consultant

  • Medicare eligibility (270-271 server), and claims processing (837 file), and explanation of services per ERN/EOB (835 file).
  • Claims processing for medical, dental, and FSA. Private insurance as well as cross billing to Medicare or Medicaid using CMS-1500 claim forms.
  • Managed a team of twenty-five claims processors and CSR's.
  • Developed and facilitated training for new and existing employees for medical and FSA claims processing and customer service.
  • Participated in contract negation with new clients.
  • Supervised contract implementation for such companies as IBM, Bank of America, AT & T, and Lucent Technologies.
  • Received Prudential President's Quality Awards for Client Satisfaction, 1996 and 1997.

Education

2 Years completed toward dual major in IT and Business Admin.
2000-2001 A Technological Advantage
MCSE Windows 2000
MCDBA
Linux Certified Professional (Linux Security and Network Admin)
CCNA - Cisco Certified Network Administrator

Military

1989-1992 US Marine Corp Camp Lejuene, NC
Financial Management
Nuclear, Biological, Chemical Warfare Training
Non-Commissioned Officer School
Company Training Non-Commissioned Officer

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