OBJECTIVE
I would like to exploit my potential for the benefit of the organization where my skills, all professional experience, academic and non academic education and knowledge can be utilized in a manner that is effective and allows for the expedited outcome to solutions across key industry sector.
KEY SKILLS & EXPERTISE
Claims
Health Insurance
Doctor Relationship
Training
Preauthorization
Strong Work Ethics
EMR & EHR
Patient Experience
Healthcare Analytics
Quality Audit
Home Health Care
Fraud Investigation
Medical Coding
Team Management
Root Cause Analysis
Medical Writing
Health Underwriting
Process Improvement
Sales & Marketing
Business Development
Medical Summarization
SELECTED ACHIEVEMENTS
Portea: Signed MOU with Apollo Hospital, Navi Mumbai and with more than 10 hospitals and more than 50 individual doctors from different specialties.
Max Bupa: Achieved Fraud Proven Rate consistently above 70% with satisfactory TAT.
Trizetto: Received honor & appreciation from US Client for Improvement of quality from 87% to 98% and maintaining throughout the tenure.
MD-India: Set new records of productivity with quality and TAT.
Ruby Hall Clinic: Best resident doctor of the year 2009.
WORK EXPERIENCE
Portea Medical, Mumbai.
Assistant Sales Manager (07-Dec-2015 to Present)
• Signing MOU with Hospitals, doctors, clinicians, diagnostic centres per different business opportunities.
Finding business opportunities with corporate, industries, institutes, etc.; negotiating price, signing deals and executing the opportunity till the process is stable with satisfactory improvements.
Target generating Business by meeting key decision makers of Corporate Hospitals and Partner Hospitals like Doctors, intensivists, ICU In-charges, Paramedical staffs, administrator and management team of hospital. Also, generating revenue by focusing on various channels like Nursing homes, Individual practicing specialists like Oncologists, Neuros, Orthos, Cardios, Diabetics Specialist, Gynaecologists, etc; others like chemists, dealers and corporate.
• Maintaining professional and technical knowledge by attending educational workshops, reviewing
professional publications, establishing personal networks, participating in professional societies, etc.
Inventurus Knowledge Solution, Navi Mumbai.
Medical Analyst (17-Nov-2014 to 04-Dec-2015)
Assisting the provider (US Physician) in navigating the EHR.
Summarizing the complete medical history of patient and analyzing it for low, medium or high critical health condition.
Max Bupa Health Insurance Company Pvt. Ltd, Pune
Sr. Executive-Field Verification (13-Jun-2013 to 15-Nov-2014)
Detailed review of patients complete case details before visiting hospitals,
Role is to verify admitted patients case file, discharge summary, pre-authorization form, admission notes etc,
Confirmation of details are relevant with patient admission and condition of claim Investigations will be focused to verify patient admission requirements relates with complaints of patients in hospital,
Patients ailment duration of claimed condition and medical history of patient has to be cross checked with patient or with his relatives to justify (PED) pre existence of claimed condition,
Need to report if any fraudulence in case details to concerned person with necessary hospital documents for rejection remarks and opinion about handled case will be updated on spot,
Triggers of handling case have to be sorted out properly with justifying evidence based investigated reports for claiming and rejecting case,
Have experience in handling team of investigators to report in cashless on daily basis and reimbursement case in specified time frame with core goal in sorting out triggers.
Trizetto, (A Cognizant Company), Pune
Quality Auditor-SLA (3-Oct-2011 to 03-Jun-2013)
Auditing adjudicated claims and generating SLA Reports of Quality,
Participating in Daily Meetings with Onshore team,
Responsible for improvement of Quality of claim adjudication
Responsible for RCA (Root Cause Analysis) of errors in production,
Reviewing Errors and taking Error Feedback Session for Adjudication Team.
MD India TPA, Pune
Medical Adviser (20-Sep-2010. 01-Oct-2011)
Responsible for claims adjudication, analysis & Investigation.
Processing all types of claims, cashless, reimbursement, health checkup and coordination of benefits between two insurance Policies.
Detecting the fraud triggers in the claim documents.
Supporting and mentoring the team for processing difficult claims.
Ruby Hall Clinic, Pune
Medical Coordinator & RMO (10-Jan-2007 to 31-Aug-2010)
Clinical Examination of patients.
Attending, examining and treating patients at primary level in Casualty.
Assisting surgeons during surgeries and procedures.
Coordinating with Health insurance companies and TPAs. for health insurance queries.
ACADEMICS
Exam passed
Board/University
Year
Percentage
S.S.C
Maharashtra Board
1996
62%
H.S.C
Maharashtra Board
2000
64%
B.A.M.S
Government Ayurved College Nanded
2006
59%
STRENGTH
Strong Analytical, Reasoning & Data Interpretation Skills.
Strong adaptability, desire towards learning different skills.
Willingness to take any challenging task and to work anytime.
Excellent communication, people management & leadership skills.
Excellent interpersonal, verbal and written communication skills.
Highly sincere, serious, optimistic, goal oriented and focused attitude.
Ability to manage varied tasks, take initiative, work with team/independently.
PERSONAL INFORMATION
Name
Asad Chand Syed
Gender
Male
Nationality
Indian
Date of Birth
03-Jan-81
Marital Status
Married
Permanent Address
296, Shobha Nagar, Near Government Workshop, Nanded, Maharashtra, 431601.
@DrAsadSyed2
https://www.linkedin.com/in/dr-asad-syed-7b056956/
DECLARATION
I hereby declare that all the above mentioned information is true to my knowledge.
Place:
Date: Asad Chand Syed