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Experiece and Highly Motivated Medical Coordinator with 10 years exper

Location:
Dubai, Emirate of Dubai, United Arab Emirates
Posted:
January 03, 2020

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Resume:

Ma. Romina B. Dominguez

*** ** **** *********

Al Nahda 2 Dubai, UAE

ada65e@r.postjobfree.com

(971-**-*******

HIGHLIGHTS OF QUALIFICATIONS

• 10-year experience in healthcare insurance industry with ICD 10, CPT-10, & Medical Terminologies.

• Good knowledge of medical and insurance rules and regulation.

• In-depth knowledge of healthcare operations

• Complete insurance and other claim forms.

• In depth knowledge of insurance policies and claims (resubmission and submission) and pre-authorization policies

Excellent Data Entry with speed type of 40-45 wpm.

SUMMARY OF RELEVANT SKILLS

• Computer Skills (MS Word, MS Excel and various processing system)

• Communication Skills (Written and Verbal)/ Telephone Etiquete

• Organizational and Clerical Skills

• Schedule and confirm appointments

• Customer Service Skill

• Ability to work independently and in cooperation with other

ACHIEVEMENTS

Received Peak Performer Award on 2018 (NTT Data Services – Dubai Hospital (Government Hospital)

Received Peak Award on 2010 - (Almadallah Healthcare Management)

WORK HISTORY

1. Admission and Medical Billing Officer December 2019 - present

Clemenceau Medical Centre

Al Jadaf, Dubai, United Arab Emirates

• Perform various admin functions such as data entry, scheduling, admitting and discharging patient etc

• Provide informed financial consent and collect payments where needed.

• Answering all patient or insurance telephone inquiries, schedule medical appointments, inform patient and medical staff.

• Checking eligibility and benefits verification for treatments, hospitalizations, and procedures

• Entering patients into computer system with demographic and insurance information, as necessary.

• Responsible for entering charges in as accurate a manner as possible, which means coordinating with the doctor's office to obtain any missing information (i.e., insurance cards, authorizations, op reports, etc.)

• Getting approval and checking validity if th services requires authorization.

• Verify if the interim invoice is billed accurately in accordance to insurance terms and condition.

2. Senior Medical Coordinator …… .. January 2017 -October 2019

NTT Data Service outsourcing Dubai Health Authority (Government entities)

Burj Al Salam, Sheikh Zayed Road Dubai UAE

• Coordinating, liaising and networking between insurance companies regarding eligibility, approvals, and other requirements.

• In-charge in obtaining OP and IP approval request along medical reports with CPT and ICD 9 or 10 codes to insurance companies through email, online entry or, and as well as taking verbal approval for urgent or emergency cases.

• Answered all patient telephone inquiries regarding their bills and insurance questions.

• Performs receptionist duties by receiving telephone calls, patients/clients, visitors, and others, answers inquiries or directs to appropriate area or staff.

• Performs clerical duties as required such as typing, record keeping and ordering supplies, entering and retrieving computerized data and patient/client information, and sorting and distributing mail.

• Provide a variety of reception services by answering telephones, operating multi-line switchboard, booking appointments and registering new clients.

• Complete insurance and other claim forms,

3. Associate Denial Management Analysis October 2014 – November 2016

Accumed Practice Management

Jumeirah Lake Tower, JLT Dubai

• Communicate with insurance companies in behalf of our client to determine denial reasons and any criteria for resubmission of claims.

• Responsible for knowledge of all contract and coverage guidelines.

• Coordinate with doctors related to medical record of patients & identified

causes of rejection & notified the same to the concerned departments

• Assess and process rejected medical claims for resubmission purposes.

• Properly process and audit all type of claims received by our clients (hospitals, medical centre, clinics), from the medical and insurance perspective.

4. Medical Claim Processor September 2009 – October 2014

Almadallah Healthcare Management

Dubai Academic City, United Arab Emirates

• Process and diagnose confidential patient conditions using examinations and tests based on medical findings; their prescribed treatment and medications

• Updates priority lists on a daily basis to determine which batches of claims needs to be evaluated and processed first to meet cheque due dates.

• Performs evaluator/doctor functions when physician is out of the office. Evaluates and process payment of insurance claims and determines whether or not to compensate such claims.

• Enter or process claims in the system with speed type of 40-45 wpm.

EDUCATION

Bachelor of Science in Chemistry 2000 – 2004

Cagayan State University, Carig Campus, Cagayan

Bachelor of Science in Nursing 2000 – 2007

Medical College of Northern Philippines, Alimanao Hills Penablanca Cagayan

Certificate in Medical Coding (CPC) 2016 – 2016

Al Talouk Medical Training Centre

REFERENCE AVAILABLE UPON REQUEST



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