John Woolley
Medical Claims Examiner at Qualcare Inc
Based in Point Pleasant Beach, United States
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Seniority
Staff
Department
Healthcare & Human Services
Location
Point Pleasant Beach
Industry
Hospitals and Health Care
Company size
200
Contact information
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j•••••••@qualcareinc.com
Phone
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Background
About John Woolley
Graduated in December, 2010 from Brookdale Community College, with a 2-year A.A.S. degree in Paralegal Studies and a 4.0 GPA. Brookdale's program is ABA approved. Interned for retired Superior Court Judge Alex Lehrer at the Risk Management office of Meridian Healthcare. Unfortunately, Meridian does not hire full-time paralegals. In addition to Judge Lehrer, my references include Claire French, the Monmouth County Clerk. I was downsized in December 2008, after 21 years with Aetna Insurance. Worked 6 years as a Claim Consultant, handling claim appeals, attorney correspondence, claim staff referrals, and inquiries from State Insurance Departments. Also served as a Team Lead and Process Improvement Consultant, helping to improve claim handling procedures and increase automatic adjudication from 35% to 70% of health claims. I am especially interested in working as a paralegal in the fields of health care, insurance, consumer protection, employment, or corporate law, but will gladly consider offers for all areas of paralegal work. Thank you for your reviewing my qualifications and profile. Specialties: Experience handling complex claim inquiries from State Insurance Departments, responding with detailed information regarding benefit decisions for all applicable claims. Supervised claim processing teams with 10 or more associates. Excellent business writing skills developed by written replies to appeals of benefit decisions for health claims.
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