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Medical Insurance

Location:
Dubai, United Arab Emirates
Salary:
10000
Posted:
October 26, 2018

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Resume:

CURRICULUM VITAE

Dr. Nadhia Farooq

Jammu and Kashmir, India

Dubai silicon oasis, DUBAI

Mobile: +971*********

Email: ac7idh@r.postjobfree.com

Dedicated Healthcare professional with 5 years of experience of working in a wide variety of healthcare settings. Skilled in Medicine, Management, Clinical research, Critical care and Insurance. Graduate Medical studies from Institute of Asian Medical Sciences.

Seeking an exciting and challenging position within a dynamic innovative Organization, where my skills and strengths will be fully utilized, where I could serve people with my knowledge and experience for better growth and reputation of the firm.

WORK EXPERIENCE:-

March 2017-present Medical insurance officer

Aafiya Medical billing services LLC-TPA(Third party administration)

Responds effectively to approval requests related to medical services both OP and IP within TAT specified. Addressing to inquiries concerning pre-authorization requests according to medical coding rules and guidelines.

Checking the eligibility, medical necessity and to make sure that the services are covered according to insurance policy terms and conditions. Report fraud and abuse cases.

Review all OP and IP cases for any discrepancy such as non-covered services, correct CPT and ICD codes, wrong deductibles no approval for services that needs approval, duplicate invoices, unjustified medical services and medication, negotiating for contracts and prices, checking network and non-network providers for better services.

Well trained in using DHPO portal, e-claim links, e-prescriptions, PBM links.

Familiar with approval and denial codes, DDC, DHA CODING, DHA and HAAD guidelines.

Process 650 fresh electronic claims/350 resubmitted e-claims per day.

Interacting with insurance companies to resolve direct billing and reimbursement claim (auditing) issues. Adjudicate all claims submitted through email, portal or courier.

Handle relationships with insurance companies, brokers and providers.

Handling network department reviewing and updating the price-lists and package deals.

March 2015-November 2016 Medical insurance officer

SHEIKH UL ALAM HOSPITAL, India

To obtain approvals for patients during the hospital working hours and providing proper information to the concerned doctors along with related queries of insurance companies. Prepare cost estimation for elective and emergency cases for admission.

Preliminary check of the completion of the forms in terms of card number/name/signs and symptoms/diagnosis/prescription/investigations done earlier/patient’s signature/stamp and sign of the Doctors.

Reviewing the status of requests and updating the concern department about the status of request whether approved, denied, query or require more details for further processing.

Maintaining records of insurance companies contracts, approval soft and hard copy, reconciliation, payment and write off status.

Answering all patients queries related to insurance-pending approvals, network, co-payment, eligibility and insurance card policy.

To settle all claims on a daily basis and following up pending approvals and dispatch them to finance and ultimately to insurance companies.

March 2014-February 2015 Medical doctor (General physician)

SHEIKH UL ALAM COLLEGE AND ASSOCIATED

HOSPITALS,INDIA

Ensuring urgent medical and nursing care to patients.

Assess the urgency and severity of presenting problems.

Recommending referrals for diagnostic and therapeutic services. Issues Treatment plan, order tests, medication and therapies.

Perform history and physical examination.

Perform rounds and record progress notes.

Arrange discharges and follow ups.

Assessing and establishing lab quality, imaging quality, infection control, drugs and equipment availability, biomedical waste management, grievance handling, duty roasters and emergency alerts.

In Unani department, dealt with all kinds of procedures (al hijaamah cupping, Acupuncture, Dalak, Nutool, Massage).

January 2013-January 2014 Resident Doctor

AHMAD HOSPITAL (SURGICAL DEPARTMENT)

Expertise in diagnosing conditions that require surgeries.

Assisted in minimal invasive surgical procedures under L/A (cyst excision, breast mass biopsy).

Lead and assist in a variety of surgical procedures to address abnormalities, injuries, birth defects, and occasionally unwanted growths from patients under a variety of circumstances.

Communicate with patients and other medical professionals to create a treatment plan that includes preoperative preparations, surgical protocols, and postoperative care.

Facilitated good Post-operative care to the patients (Pain management, ambulation, wound care, maintaining vital sign charts, rounds and ASD at proper time).

Ensured discharge of patient with DO AND DON’T chart.

February 2012-November 2013 INTERN DOCTOR

Dr. Bilquees day-care clinic(GYNAE & OBS)

Attended women with general health issues and reproductive health conditions.

Assisted her in various surgical procedures (Dilation and curettage, tubal ligation, LSCS).

Educated patients on practice that promote wellness and health (breast self-examination, personal hygiene)

Conducted various normal deliveries under proper supervision.

Treated wide range of common women’s issues (PCOD, irregular cycles, genital infections).

EDUCATIONAL BACKGROUND:-

Bachelor’s in Unani medicine and surgery (BUMS) (homeopathy) from University of Kashmir (India) in 2012 with

Secured 67% in First proff (University Topper)

Secured 66% in Second proff (3rd Topper)

Secured 63% in third proff (2nd Topper)

Passed Higher Secondary through J&K BOSE with 73%.

Passed High school passed through J&K BOSE with 79%.

PROFESSIONAL ACTIVITIES:-

1.Participated in AROGYA 2009 held in Kashmir 2009 organized by Department of AYUSH, Ministry of health and family welfare.

2.Visited Psychiatry hospital on world mental health day on 10 Oct 2013.

3.Participated in every pulse polio campaigns in J&K from Jan 2012 to Jan 2014.

4.Participated in inter college seminar held on WORLD TUBERCULOSIS DAY and positioned 2nd.

5.Participated in drive of RBSK (RASHTRIYA BAL SAWSTHYA KARYAKARAM) in 2015 organized by National health mission by GOVT of India.

6.Participated in cross country run in high school organized by Kashmir Private school association.

Positive traits:-

i.Focused, punctual and committed towards work.

ii.Excellent communication/interpersonal skills and a quick learner.

iii.Ability to prioritize workloads during busy periods.

iv.Computer skills

Microsoft office-Word, Excel, Access and power point.

Outstanding Typing Skills.

Email, Outlook Express, Social Media, and Blogging.

Spread sheets and Databases.

v.Adaptable according to ambience.

PERSONAL INFORMATION

Name: - Nadhia Farooq

Father’s name: - Farooq Ahmad Wani

D.O.B:- 3rd Nov 1985

Marital status: - Married

Nationality/Religion:- Indian/Muslim

Passport no: - M2184016

Reference in UAE: Salman Babar Shora (Husband)

Service Manager

DU Telecommunication

Mobile: +971*********

I, hereby declare that information furnished above is true to the best of my Knowledge.

Place: Nadhia Farooq



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