Executive Summary
Give a brief description about who you
are as a professional. What do you do?
Why do you do it? What do you like
about your field of work*
Languages
Language - Level of Mastery
Skills
Technical Skill 0 0 0 0 O O
Out of Office
How does it benefit you?
Why do you like this activity?
Certification
Certification
Organization
MUSTAQ AHMED MOHAMMED
Senior Executive
Email id @
adxqfj@r.postjobfree.com
Contact No 974-***-****,866*******
Location: Mysore, Karnataka
Summary
Precise, efficient medical billing professional with over 5 years of physician medical billing. Specialized in filing accurate claims, adjusting rejected claims, and understanding insurance contracts, appeals, and EOBs
Software’s:
. GE Centricity
. Allscripts
. OncoEMR
. Prism
. Xifin
. Imagie
WORK EXPERIENCE
SENIOR ACCOUNT EXECUTIVE
Omega Healthcare Management Services
Private Limited
Bengaluru, Karnataka, India
04/06/2018- 30/11/
2020
• Review of daily AR and Denial report for Accounts receivable and planning the workflow to follow up with the payer for payments
• obtaining Explanation of benefits from payers and posting the payment in the software • Daily review of EDI rejections and payer rejections and correction of those rejection and resubmission of claims
• Investigating for payer denial patterns and reducing the AR days to 90 days and below • Resolving Provider quires through emails
• Training and resolving the quires of colleagues
• Preparing the Appeals for Medically necessary, crossed timely filling limit, Authorization for services and Co-ordination of benefits
• Verification of patient Eligibility and coverage information
. Review of correspondence letter received from payer and maintain the TAT. Sysinformation Healthcare India Pyt Ltd.
{O5/23/2Ol5-O6l9/2Ol7)
Mysore, Karnataka, India
• Daily review of denial report from the insurance payer and correction and resubmission of claims
• Follow up with the payers for claims and sending the claims back for reprocess which are denied by the payer in error
• Preparing the Appeals for Medically necessary, crossed timely filling limit, Authorization for services and Co-ordination of benefits
• Verification of patient Eligibility and coverage information
• Obtaining retro -authorization for services which are missed to be obtained prior to service being performed
• Daily review of EDI rejections and payer rejections
. Working on collection ‘s report in month end.
Decipher Health
Records LLP (OIO3/2Ol8-
05/28/2018)
Mysore, Karnataka, India • Daily review of denial report from the insurance payer and correction and resubmission of claims
• Follow up with the payers for claims and sending the claims back for reprocess which are denied by the payer in error • Preparing the Appeals for Medically necessary, crossed timely filling limit, Authorization for services and Co-ordination of benefits • Verification of patient Eligibility and coverage information
Senior Process Associate
Jorie Health private
limited Mohali,
Punjab, India 12/2/2020 –
03/7/2022
. Verification of patient Eligibility and coverage information
. Review of daily AR and Denial report for account receivable and planning the work flow
. Review of correspondence letter received from payer and maintain the tat
. Training and resolving the quires of colleagues
Senior Process Associate
NYX MEDICAL Solution Pvt.
Chennai, India
08/02/2022- Current date
• . Daily review of denial report from the insurance payer and correction and resubmission of claims
• . Follow up with the payers for claims and sending the claims back for reprocess which are denied by the payer in error
• . Verification of patient Eligibility and coverage information
• Obtaining retro -authorization for services which are missed to be obtained prior to service being performed
EDUCATION
B.SC
Yuvaraja’s college
Start Date - End Dote
COURSES
C.B.Z (CHEMISTRY, BOTANY, ZOOLOGY)
MYSORE UNIVERSITY
Scan the QR code to view my online resume with more information about my career.