Quality Assurance Specialist

Mahmood Ahmed Qureshi. MD

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

Phone: 202-***-****

LinkedIn: www.linkedin.com/in/mahmood-qi

Summary:

Experienced Clinical Quality Assurance Specialist with expertise demonstrating Quality Medical Review/ OASIS/Coding competency and a proven track record of Dermatology experience and ensuring compliance with regulatory guidelines. Skilled in identifying and mitigating risks when conducting regular documentation audits, and developing quality management systems.

Objective:

Interested in demonstrating how I could be a great addition to your team of Medical Coders.

Educational Qualifications:

American Academy of Professional Coders Certified Professional Coder (C.P.C.) August 2024

Saudi Licensing Examination (S.L.E); Riyadh, Saudi Arabia Mar 2007 Dermatologist Registrar

King’s College London; London, UK Oct 2001-Sept 2002 Masters in Science (Dermatology)

Baqai Medical College; Karachi, Pakistan Oct 1990 - Sept 1995 Bachelor of Medicine, Bachelor of Surgery (M.D)

Professional Experience:

Healing Home Healthcare Apr-2021-Present Quality Assurance Specialist

• Performed thorough Oasis/ Chart Review to ensure appropriate responses based on medical record documentation, clinical and coding guidelines.

• Sequenced/ Applied diagnosis codes for accuracy, completeness and appropriateness according to

services rendered and supporting medical documentation.

• Quality chart reviewed: Medicare, Medicaid, Private Insurances

• Regular Compliance in accordance with Quality Check and Analysis under the standards set by

CMS

• Manage the Quality Management System (QMS) for patient assessments, ensuring compliance with regulatory guidelines and SOPs

• Review the Comprehensive SOC OASIS Assessment and Plan of Care

• Assure consistency with the Comprehensive Assessment and the Plan of Care

• Assure the appropriate diagnostic procedures are obtained relative to patient condition.

• Review the F2F documentation

• Review documentation ensuring the physician orders are followed

• Ensure that Discipline frequency correlates with the assessment data.

• Review and process all OASIS data-Transfer, ROC, RCT, Follow up

• Review and process the Discharge OASIS

• Perform timely OASIS submissions

• Monitor for Declines or Improvement in patient outcomes

• Participate in the development of in-services and individual clinician training.

• Quality control when doing Validation checks while assessing SN initial and subsequent follow up visits with respect to Physician orders for Principal Diagnosis and other chronic conditions.

• Collaborate with cross-functional teams to develop risk management plans and ensure timely resolution of quality issues

EDU Healthcare Sep 2020- Apr 2021 Patient Care Assistant

• Provided personal care to students with special needs, such as assistance with toileting, feeding, dressing, and grooming.

• Assisted students with mobility and transfers, such as transferring them from a wheelchair to a desk or helping them navigate stairs and hallways.

• Administered medication to students according to the instructions of the school nurse or other healthcare professional.

• Monitored and recorded vital signs, such as temperature, blood pressure, and heart rate, and reporting any changes to the school nurse or healthcare professional.

• Implemented and monitored behavior plans for students with behavioral challenges, and reporting any concerns to the appropriate school staff.

• Provided supervision and support to students during lunch, recess, and other non-academic activities.

• Collaborated with teachers, therapists, and other school staff to ensure that students are receiving the appropriate support and care.

• Documented student progress and communication with parents and healthcare professionals, as needed.

• Participated in professional development and training opportunities to stay current on best practices in patient care.

What Al Shifa Clinic; Jeddah, KSA Jan 2020 – Aug 2020 Dermatologist

Conduct complete skin examinations.

Counsel patients on topics such as the need for annual dermatologic screening, sun protection Record patients' health histories.

Diagnose and treat skin conditions such as acne, variety of dermatitis, different type of infections, psoriasis etc.

Perform incisional biopsies in accordance with in order to have a conclusive diagnosis. Perform excisional biopsy for cystic lesions, incision and drainage of abscess, debridement and dressing of ulcers

Ourisman Chantilly June 2018- Jan 2020 Accountant

Prepared asset, liability, and capital account entries by analyzing accounting data

Performed database backups for securing financial information

Audited financial documents

Managed accounting data in different databases

Reconciled financial discrepancies

Naseem Jeddah Polyclinic; Jeddah, KSA Nov 2010 – Apr 2018 Dermatologist

Examined patients to determine the nature of disease.

Discussed skin conditions such as dermatitis (exogenous and endogenous), with patients. Supervised nursing staff

Performed laboratory procedures and ordered any necessary diagnostic testing.

Developed a treatment plan for skin conditions.

Determined the cure and helped patients with preventive methods.

Procedures done during out- patient clinic services such as Chemical peeling for xanthelasma, Melasma, Acne scars, Post inflammatory pigmentation, Mesotherapy for hair loss.

Taj Polyclinic; Jeddah, KSA Oct 2007 – Aug 2010 Dermatologist

Examined patients of different age groups neonatal, infantile, children and adults with a variety of skin disorders most specifically: All types of dermatitis including Different forms of bacterial, viral and fungal infections, Scabies, acne, Photosensitive disorders, Cases of different forms of drug eruption, Different types of psoariasis, Disorders of keratinization, Connective tissue diseases, Sexually transmitted diseases

Depending on nature of diseases ample time given to patients for counseling and treatment options. Treated various types of benign lesions, surgically removed and performed Biopsies. Procedures done during out-patient clinics including Electrocautery for warts and molluscum, Intra lesional therapy for keloids, chronic dermatitis and alopecia.

Thadiq General Hospital; Jeddah, KSA Sept 2004 – Aug 2007 Dermatologist

In addition to out-patient clinic, regular ward rounds also done for admitted cases Managed emergencies in ER such as: cases of first and second degree burns, cases of drug reaction, anaphylactic reactions urticarial vasculitis, angioedema, blistering disorders, debridement and dressing for various ulcers.

Aga Khan Diagnostic Center; Karachi, Pakistan Nov 2002 – Jun 2003 Dermatologist

While seeing patients in out-patient clinics, this medical center has polished my career to show proficiency in the field of dermatology by having a good communication skill, a good negotiation and interpersonal skills, good consultation skills and custom service, and a high standard of computer literacy.

Orthopedic, Maternity and General Hospital; Karachi, Pakistan Sept 1998 – Sept 2001 Postgraduate trainee (Dermatology)

Assisted each doctor in a variety of basic in-office surgical procedures.

Responsible for making sure that each patient's chart was updated properly after each appointment. Assisted in explaining the potential effects of medications that were prescribed by doctors.

Jinnah Postgraduate Medical Center; Karachi, Pakistan Mar 1998 – Aug 2000 Postgraduate trainee (Dermatology)

Assisted doctors in setting up and executing informational clinics for patients.

Assisted in basic examinations and often kept notes for doctors.

Responsible for confirming each day’s appointment at least one week in advance.

Assisted in checking patients out when the appointment was over and distributing any necessary information.

Skin Care Center; Karachi, Pakistan Oct 1997 – Apr 1998 Resident Medical Officer (Dermatology)

Appropriately diagnosed and treated a wide variety of skin diseases.

Ordered and executed diagnostic tests.

Lead dermatology prevention and health promotion to increase awareness of diseases. Internships:

Jinnah Postgraduate Medical Center; Karachi, Pakistan Oct 1996 -Apr 1997 General Medicine

Jinnah Postgraduate Medical Center; Karachi, Pakistan Apr 1996 – Oct 1996 Chest Surgery

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