Insurance Medical

CURRICULUM VITAE

PROFESSIONAL OBJECTIVE

Looking for a position where I could expand my learning and ability to do work and to gain

knowledge and experience that are related to my profession to be an excellent Insurance

Coordinator and to become an asset to your company.

QUALIFICATION PROFILE

•An Insurance coordinator $ Medical Billing with almost 2 years of experience covering all areas

of Hospital and Medical centre.

•An excellent Insurance skill.

•Excellent in computer and communication skills.

•Flexible, enthusiastic, fast learner, hard working, and has the ability to adapt with multicultural

environment and to do work with a minimal supervision

. OCCUPATIONAL HISTORY

• Worked as a Health Insurance Claim and Medical billing Co-coordinator cum staff nurse at

Puthiyedom Hospital,Poovarny,Paika,Kerala,India.[SEP 2009 to SEP 2011]

• Worked as a registered nurse at Dr.D.Y.Patil Medical college and Research centre,Navi Mumbai.

( NOV 2007 to MAY 2009) •

HEALTH INSURANCE COORDINATOR

PUTHIYEDOM HOSPITAL,PAIKA,POOVARNY,KERALA

September 2009 – Sep 2011 (3 years)KERALA,INDIA

DUTIES AND RESPONSIBILITIES

Processing of outpatient requests for approvals.

Dealing with all the famous health insurance companies

Primarily provides all kind of insurance assistance to hospital departments, branches.

Review and verify patient account information against insurance program specifications.

Gain as much knowledge in medical insurance terms and condition

Develop good relationship with various insurance companies

Update ourselves with latest medical terminologies and information

Check hospital bills to avoid any errors to minimize rejections.

Receive rejected claims from various insurance companies

Rejected claims to be rectified by providing the requirements needed by the insurance company.

Liaise with doctors and other departments for the purpose of rectifications

Liaise with staff and doctors of insurance companies.

Provide all necessary assistance regarding insurance supervisor to all the departments and doctors.

Obtain approvals as per the request of the doctors from various insurance companies

Proper filing of approval and other correspondences

Promptly deliver all the mails and memos from various insurance companies to insurance

supervisor

Deliver all mails and memo to various departments of the hospital

Provide full support to the HOD for smooth functioning of the departments.

Maintain proper records of approvals and rectification statements

To understand principle of medical coding.

Dealt with Hospital Information System (HIS) and 3M software

Usage of insurance software HITS and other hospital software

Be actively involved in the quality improvement

Health insurance clerk and Medical Billing

INSURANCE CLERK AND MEDICAL BILLING DUTIES $ RESPONSIBILITIES

ϖ File opening, billing, invoicing.

ϖ Maintaining of various registers and documents.

ϖ Client service

ϖ Collecting the cash from patients. (Cash, visa card, etc.)

ϖ Settling the bills.

ϖ Insurance submitting.

ϖ Updating Insurance companies file as per the latest circulars/ information received from

Insurance companies

ϖ Taking prior approval for lab investigations and other procedures, in case required as per the

agreement with the Insurance companies.

ϖ Giving clarifications to the concerned person in Insurance companies regarding the sent claims.

ϖ Contacting Insurance companies for getting claim forms.

ϖ Collection of claim forms from the concerned departments as per the invoices.

ϖ eClaim Express online

ϖ Collecting deduction and co insurance from insurance patient.

ϖ End of the day tallying the daily report with the cash received.

ϖ Handling over the cash to account and closing the cash counter.

ϖ Resolving the customer’s problems.

REGISTERED NURSE

DR.D.Y.PATIL MEDICAL COLLEGE AND RESEARCH CENTRE,NAVI MUMBAI

November 2007 – May 2009

JOB RESPONSIBILITIES

¬ Maintain the highest possible standard of patient care

¬ Documentation of nursing activity in brief

¬ Vital signs checking

¬ Comprehensive assessment of patient including history, physical examination family/caregiver

interview, evaluation of cognitive functional performance and affect.

¬ Record pertinent patient data

¬ Remove suture

¬ Assist simple I$D of abscess

¬ Giving medication with doctor’s order such as antihistamines, pain relievers, cardiovascular

drugs, and disinfectants for agents used object other than skin, antitussives, expectorants and

mucolyticsagents. Gastrointestinal drugs and vitamins.

¬ Start intravenous lines

¬ Administer suppository, subcutaneous, I.M, or I.V, medications.

¬ Wound care

¬ Nebulization

¬ ECG taking

¬ Cardio pulmonary Resuscitation

¬ Cary out aseptic and isolation techniques

¬ Patient education/ health teachings

¬ Spirometry

¬ Sterilization of the instruments.

EDUCATIONAL QUALIFICATION

Diploma in General Nursing and Midwifery

Bachelor degree in Business Administration

Pursuing MBA in Hospital Management .

ADDITIONAL SKILL

. Excellent communication skill with an IELTS score of overall 5.5

. Ability to work with several operating system including all windows MS

office and internet too.

. Knowledge in CDT codes, preparation of invoices, knowledge of e-claim

process

. Hardworking,Flexible,Energetic and a supportive team player.

MY PRESENT STATUS

Presently working at Carrefour Dalma Mall,Abu dhabi as a First aid team leader cum

Customer care executive from 6/12/2011 till present.

DUTIES AND RESPONSIBILITIES

• Attracts potential customers by answering product and service questions;

suggesting information about other products and services.

• Opens customer accounts by recording account information.

Maintains customer records by updating account information.

•

Resolves product or service problems by clarifying the customer's complaint;

•

determining the cause of the problem; selecting and explaining the best

solution to solve the problem; expediting correction or adjustment; following

up to ensure resolution.

Maintains financial accounts by processing customer adjustments.

•

Recommends potential products or services to management by collecting

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customer information and analyzing customer needs.

Prepares product or service reports by collecting and analyzing customer

•

information.

Contributes to team effort by accomplishing related results as needed.

•

Publications

HEALTH INSURANCE COORDINATOR AND MEDICAL BILLING

Dear Sir,

As a person with high respect for your company and with earnest desire to be associated with you

seeks to serve you in capacity of Insurance coordinator & medical billing. I am here by submitting

my resume for your kind perusal and consideration. Please consider me as an applicant for the

position. If my application has convinced you of my ability to satisfy you, I would like to have the

opportunity to talk with you and you may judge my personal qualification.

Respectfully yours,

Lijo Babu

Mob: 009***********

Email id: ********@*****.***

Contact this candidate