Medical Insurance
Resume:
RESIDENCIAL ADDRESS
Muhamed Faisal.M
Melethalakkal
E-mail: adb5lp@r.postjobfree.com
Al Sadd, Qatar-Doha
LANGUAGE PROFICIENCY:
English: Fluent in speaking &
writing
Malayalam: Mother Tongue
Tamil: Speak
Hindi: Read & Write
Arabic: Read & Write
COMPUTER SKILLS:
Ms Excel & Ms Word
Tally ERP 9, Peachtree
Access in Internet & Email
Fast Typing & Keyboard
Skills
CURRICULUM VITAE
OBJECTIVE:
To work with a goal oriented team that can provide challenging environment and career oriented growth paths for learning and serving, where I can contribute in maintaining the system with the strength of my education, skills & experience. To manage multiple tasks & assignments under extreme pressure. PROFILE IN BRIEF
Graduated in Finance, with 2 years of work experience in Accounting in a reputable firm
Work as medical insurance coordinator in a polyclinic center since 2014 up to present
Highly knowledgeable in various accounting packages like Tally Erp.9, Peachtree.
Handled HR Operations such as maintaining payroll, calculation of employee’s benefits
Performed Net Banking
Maintained daily basis documents
Knowledgeable in Ms Office operations
Monitored the financial information system ensuring that timely and accurate information is provided for managerial decision making ACADEMIC QUALIFICATIONS
BACHELOR OF COMMERCE September 2013
Calicut University, India
PLUS TWO March 2009
Government Of Kerala
S.S.L.C March 2007
Government Of Kerala
PERSONAL PROFILE:
Date of Birth: 04th May1992
Age: 27
Marital Status: Single
Religion : Islam
Nationality : Indian
Visa status :Work Visa
Qatar ID.No. : 292********
Passport No :K 3054264
REFERENCES:
Mr. shajahan
Contact Number: +919*********
Occupation: Managing Director
Kpm sanitation
Place:palakkad kerala
Mr. veeran kutty p
Contact Number: +919*********
Occupation: Managing Directer
City Bazaar.
Place: palakkad kerala
Dr. Osama Al Dulaimi
Contact Number: +974-********
Occupation: Medical Director
Qatar Medical Center.
Place: Doha Qatar
WORK EXPERIENCE
I.)Insurance Coordinator - Qatar Medical Center, Doha, Qatar December 24, 2014 - Present
Roles & Responsibilities:
Process and send approvals or prior-authorizations to insurance for the procedures based on insurance companies’ approval requirements upon doctor’s requests
Coordinate, do liaising and networking between insurance companies regarding eligibility, payments, approvals and other requirements
Coordinate with various departments such as Administration, accounts, different clinics & other departments related to accounts, insurance issues and other medical related problems
Processes medical claims and submit within the instructed time
Collect and maintain the payments of submitted claims
Reconciliation of the insurance accounts.
Coordinate with the staff like doctors and nurses and answering their queries related to insurance
Assists patients regarding their insurance questions or any queries regarding unpaid balances
Guides team members to achieve maximum result to the department
ICD 10 Coding in various insurance companies
Assists to the billing related issues and guiding them for smooth work flow
Manages filing and tracking insurance claims and informed patients of their claims status
Adding new Insurance Schemes and adding new procedures as required
SUBMISSION OF CLAIMS:
E-claim submission: Prepares SOA, XML and compare both for the number of claims to be uploaded and tallying the total amount billed to insurance. Do solving in XML errors on uploading to DHPO.
Paper claim submission: Submit paper claims to different insurances preparing SOA and required document and communicate to insurance companies for any discrepancies or submission related issues
Additional role:
FRONT OFFICE SUPPORT/RECEPTION:
Register patient’s information properly
Input insurance companies and collects co-payment and deductible
Verify the insurance eligibility
IT SUPPORT:
Troubleshooting in any system or network related, printer related or PC related issues
Keeping the software up to date
Creating new users and assigning their updates and changes Handling IT related issues and solving software issues accordingly FOCAL POINT FOR LICENSE PROCESSING
Prepare applications and apply for all the medical staff’s licenses as a new applicant or renewal in the QCHP online system
Guide them for the requirements needed for the evaluation and dataflow processes and apply it online
Update CPD points in staff’s portfolio and assists them how to input independently
Prepare and apply online for the renewal of medical center’s license
Update and submit the price lists from the different clinic in the medical center
ACCOUNTS:
Handling Petty cash
Check and make report for daily cash
Making CPT/ICD changes to software
II.) Accountant K.P.M SANITATION, Kerala, India
January 01, 2014 – October 05, 2014
Roles & Responsibilities:
Updated transactions of all business related entries in Tally and Ms-Excel
Analysis of trade receivables and trade payable
Verification of day to day payments and receipts
Prepared 2-way match between Purchase Order and Purchase Invoice, Sales Order and Sales Invoice and followed- up of sales invoices and Credit notes.
Prepared reports for management
Ageing of client Accounts
Arranged Fund Transfers (Local and Overseas).
Prepared Bank reconciliation statement
Prepared PDC (Post Dated Cheque) and CDC (Current Dated Cheque) operations
Managed the HR operations- Monthly salary transfer and calculation of employee’s terminal benefits
Calculated the sales commission
Monitored bank balance
Arranged the finalization of accounts
III.) Accountant CITY BAZAAR, Vallapuzha, Pallakad, India July 02, 2012 to Deccember 23, 2013
Roles & Responsibilities:
Prepared daily cash book, bank book, purchase, sales and other general ledger accounts
Recorded voucher entries
Maintained day to day documents
Verified the vouchers with supporting bills
Assisted in stocktaking and evaluation of stock
Prepared bank reconciliation statement, debtors and creditors reconciliation
Prepared monthly profit and loss accounts, balance sheet, cash flow statements CAPABILITIES
Organized – able to do multi-tasking and prioritize them effectively and accordingly
Effective problem solving abilities
Good teamwork, manages escalations and good and active listener
Outstanding communication skills – interact both with clients and cross-company workers through verbal and writing
Adaptability and time management- able to work under pressure and adjust upon the situation and the environment
I, hereby declare that the information given above is correct and complete to the best of my knowledge and belief. If given an opportunity in your esteemed organization, I assure you that, I will fulfill my duties, entrusted to me, up to the perfection, to the satisfaction of my superiors and higher officials. MUHAMED FAISAL.M
Place: Salwa Road, Doha, Qatar
Date :
REFERENCE WILL BE AVAILABLE ON REQUEST
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