Manager Insurance

BIO DATA

K HAN SONU RAF I AH M E D

Contact Information:

Plot no, 42/P/06, Shivaji Nagar,

Govandi, Road no.06,

Mumbai: - 400 043

Contact no: +91-897*******

Email: - ************@*****.***

Current Position: Sr. Associate cum Denial Management.

Current Company: Southside Health Care Solution / Pharmacy.

Qualification Details:

Qualificatio YEAR OF BOARD Grade

n PASSING

B.Sc. APRIL 2011 MAHARASH 58.59

(Physics) TRA %

66.66%

H.S.C. MARCH 2007 MAHARASH

TRA

73.73%

S.S.C. MARCH 2005 MAHARASH

TRA

PROFESSIONAL COMPUTER COURSES:-

1. M-S office + internet + excel-outlook

Work Experience:-

• Working in Southside Healthcare Solution /Pha rmacy as Medical

B iller cum A/R & Denial Specialist for Gastroenterologist, [ Infusion

t herapy for All d rug like …Remicade( Infliximab), Boniva( Inj.

I band ronate), Orencia(inj. Abatacept), Benalysta(Belimumab) etc.. for

Doctor Side (22nd M ay 2012 – up to the date)

• Checking Eligibili ty,

• Billing Claims & Creating Invoices

• Charge Posting

• Payment posting

• Correspondence

• Working on Denial

• Insurance Follow-up

• Process maintenance requests, substituting for manager as needed.

• Direct contact with US insurance regarding claim Status & Queries

• Work finish within 48 H rs.’ as per task.

• Train to new Employees

• Making Monthly revenue report

• Doing R&D to improve the process.

• Maintaining Medical document (Nurse note, Pathology report, Lab report etc….

• Supporting to team and helping him & solving problem which work related.

Also examine the claim whether claim billed correctly or not.

PREVIOUS EXPERIENCE

• Working as I nsurance Coordinator cum A/R (Collection) and Working

on Denial in Health Prime In ternational from May 2011 to April 2012.

(Work for T enet Florida M D L LC . For P hysician side and Worked for many

specialist doctors

l ike Gynecologist, Cardiologist, Gastroenterologist, Hematologist etc…. )

• Checking Eligibili ty,

• Charge Posting

• Payment posting

• Correspondence

• Working on Denial,

• Insurance Follow-up

• Process maintenance requests, substituting for manager as needed.

• Direct contact with US insurance regarding claim Status & Queries

• Work finish within 48 H rs.’ as per client Need

• Train to new Employees

• Maintaining Medical document (Nurse note, Pathology report, Lab report etc….

• Supporting to team and helping him & solving problem which work related.

Also examine the claim whether claim billed correctly or not.

I had Experience with almost all the insurance company like Medicare, Medicaid,

Avemade, All commercial payers like Aetna, Cigna, BCBS, Molina etc….

I have experience with NextGen and I have complete knowledge of NextGen.

OBJECT IVE :-

Looking for an opportuni ty where I can prove my quality.

I should remain always learning as to achieve Goal with the aim and working for

the Goodwill of a reputed organization.

SOFT SKILL :-

1. Good grasping power

2. Confidence to face challenges in life

3. Able to handle pressure and perform well.

PERSONAL DETAILS:-

Name : K han Sonu Rafi Ahmed

Father Name : K han Rafi Ahmed

Date Of Bi r th : 20th June 1989

Mari tal status : U nmarried

Nationality : I ndian

Gender : M ale

Hobbies : listening songs.

Language known : E nglish, H indi, Marathi & Urdu

Passport No : L4770857

Passport(Validity) : Sept 2013 to Sept 2023 (Ready

to relocate)

I hereby declare that all specifies mentioned here are t rue to the best of my

k nowledge and belief.

P lace: Mumbai yours

faithfully

Date:

K han Sonu Rafi

A hmed

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