Will no longer needs a job!!!!

I accepted a position with Multicare Health Systems as a Contract Reimbursement Analyst. My first day is June 8th 2009. Hooray!!!

Resume

William Frazier

willhfrazier@gmail.com

At a Glance

Bachelor of Science in Organizational Communication
Claims Analysis Experience
Understanding of Insurance Contract Language, EOBs, Uniform Bills, Patient Liability, and Coordination of Benefits
Passion for simplifying health care and creating affordable solutions
Highly adaptable to fast-paced environments
Consistently exceeded ambitious monthly goals for identified dollars

Career Objective

Experienced Claims Analyst with proven expertise in reviewing insurance claims for an established health care company, resulting in significant cost savings, seeks to obtain a position which values problem solving and critical thinking skills.

Experience

Regional Account Manager, AIM Healthcare Renton, WA Sept 2008 - Nov 2008

Responsibilities for this position include identifying and documenting overpayments made to the hospital by evaluating the hospital's credit balance report. If a claim is found to be paid incorrectly. then a refund or a debit balance must be requested and the inaccuracy is documented through the use of spreadsheets and company software. This position requires a thorough understanding of coordination of benefits, contract language, and patient liability, in addition to current state laws and regulations related to health care. Brief tenure due to discontinuation of company's services.

Claims Analyst, AIM Healthcare Franklin, TN Oct 2007 - Sept 2008

Responsibilities for this position include identifying overpayments by comparing insurance contract language to claim payments resulting in a minimum of $500,000 per month returned to client. A Claims Analyst must have an understanding of insurance company's claims adjudication system, provider contracts, and basic client/claim payment policies. This position requires the ability to work cooperatively with all team members to ensure project goals are met. Communicating ideas and information to coworkers is essential to the success of the team. Analysts must also meet ambition goals for identified dollars each month.

General Manager, Ben & Jerry's Franklin, TN May 2004 - Oct 2007

Responsibilities include all aspects of business operation: customer service, tracking sales, labor, inventory, project delegation to fellow employees, marketing. The responsibilities I found most satisfying were recruiting, interviewing, and training employees. In addition, I sought to involve the company in fundraising events for community non-profit organizations.

Education

Middle Tennessee State University, Murfreesboro, TN

Organizational Communication 2005

Professional Activities

Co-founder, Tacoma Job Club Tacoma, WA Dec 2008 - present

Founding member of the Tacoma Job Club which is a social group that consists of other job seekers. The purpose of this group is networking, offering accountability and encouragement to other members in their job search. The group has grown to over 60 members and we have expanded into Seattle, Bellevue, and Olympia.

Ambition

The most important skill I have acquired through my education and work experience is the ability to learn and adapt to changing environments. Shifting from a food service management position to analyzing health care claims was challenging, but rewarding. I am motivated by problem solving and finding methods to achieve goals in increasingly efficient ways.

Introduction

I moved to Tacoma, Washington last fall with my wife. I was able to transfer to a new position with the company I was working for in Franklin, Tennessee. Unfortunately, due to the current economic climate, I was laid-off 3 weeks after starting. My work experience is in claims analysis.

As a Claims Analyst for AIM Healthcare, I gained experience analyzing insurance contracts and hospital billing procedures. In this position, I became adept at identifying potential refunds by evaluating insurance contract language and hospital claim payments resulting in significant cost savings for clients. Claims are paid incorrectly for a variety of reasons. It was my job to evaluate hospital contracts and claims to identify and document trends. When refunds are identified I would write refund requests explaining the reason for the infraction. 

When I transferred to the position in Washington I learned an entirely new set of skills. As a Regional Account Manager, I evaluated hospital credit balance reports in order to identify refunds based on coordination of benefits and contractual analysis. 

Both of these positions require organization, communication, and analytical skills, as well as thorough knowledge of health care terminology and payment methods. An in-depth understanding of patient liability methods such as copays, coinsurance, and deductibles were essential to performance in both of these positions.

In addition to my experience in this field, I have completed a Bachelor's degree with a major in Organizational Communication. The major's focus includes business, diversity, and interpersonal communication, as well as general business related courses such as management, marketing, and accounting. 

During my job search I helped found a professional networking group called the Tacoma Job Club (http://job-club.org). The job club has 3 purposes: provide accountability for other job seekers by holding each other to task in our individual job searches, offer encouragement to members, and share resources. The Tacoma Job Club has grown from 2 to over 50 members in less than 3 months. We have also expanded the club into surrounding areas.

My education and work experience have provided me with the skills necessary for a position involving claims analysis or processing. Please contact me if you have any suggestions or would like to pass any information along.