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Manager Medical

Location:
Dubai, Emirate of Dubai, United Arab Emirates
Salary:
7000
Posted:
March 16, 2020

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Resume:

Preauthorization, Medical Coding & Billing Professional

Kiran Liaqat Ali

Summary

I would like to be a part of dynamic organization that enables me to exhibit my potential knowledge and skills to grow professionally and be a positive contributor to the organization. Want to work as an advancing medical coding professional in a challenging and fascinating working atmosphere with the utilization of adept coding expertise and proficiencies. I would like to exploit my 7 years Health Care international experience in your organization.

Personal Information

Date of Birth 20-Nov-1988

Passport No. CN896551

Marital Status Married

Educational Background:

Graduation, Bachelors in Business Administration (BBA) Preston University, Pakistan

Intermediate of commerce (I. COM)

Lahore commerce College, Pakistan

CHRM- Certification in Human Resources Management

Pakistan Institute of Modern Studies, Pakistan

Certification in Medical Coding

Al-Talouk Medical Coding Centre, Dubai

Certification in Medical Dental Assistant with 1 year Internship Dental Professional Hospital Lahore Pakistan

MS Office Word and Excel full command certification Virtual university of Pakistan.

Hands on Experience Software

Fidelio software, Hospital information system (HIS), Sage Accpac software, Mediware Software Voice: +971**-*******

adcbg0@r.postjobfree.com

Preauthorization, Medical Coding & Billing Professional Professional Background:

Medcare Hospital Sharjah

(Period: April, 2018 till to Date)

Position Title: Pre- Authorization Officer (In-Patient & Out-Patient) Al Zahra Private Hospital, Dubai

Period: April, 2014 to April 2018 (4 -Years of Service) Position Title: Pre- Authorization coordinator (In-Patient & Out-Patient) Saudi German Hospital, Dubai

Period: November, 2011 to January, 2012 (Got promotion after 3-months of time period) Position Title: Customer Service Officer

Period: January, 2012 to March, 2014 (2-Years of Service) Position Title – Claims submission Officer (In & out Patient) Dental Professional Hospital, Pakistan

Period: January, 2010 to January, 2011 (1-Year of Service) Position Title: Dental Assistant

Work Experience:

Medcare Hospital

Roles & Responsibilities:

Deals with international GOPs for IP and OP.

Deals with local insurance companies for in patient and out approvals.

Deals with in house doctors to maintain medical reports.

Deals with online portals next care (pulse, E claims, MedConnect, Al buhaira, AXA dental portal ETC).

Reviewing and cross verifying CPT and ICD codes before getting approvals.

Follow ups with CBD doctors and CBD clinics for approval and denials.

Daily follows up with insurance companies for approval, denials and inquires through all medium of conversation: E mails, Tele conversation Faxes online authorized system with full record. Verifying the each bills of insurance with claim form and patient card copy in timely manner.

Solving patient's problem. Multi-tasker. Performing any Job/Tasks as and when assigns by the manager.

Reporting daily approval and denial to insurance manager.

Regular and timely follow up on pending issues with the concerned Insurance companies.

Approval maintain in Mediware software.

Deals with inpatient and outpatient cashiers for deductible and copayments. Preauthorization, Medical Coding & Billing Professional

Deals with submission queries and gets approval for old cases.

Completing tasks on time for approval re approval and submission. Al Zahra Private Hospital, Dubai

Roles & Responsibilities:

Deals with National and International Health Insurance Companies.

Developed Good relationships with various insurance companies. Communicating international agencies for referrals of patients.

Involved in the process of getting approvals from respective Health Insurance Companies.

Coordinating with concerned physicians in preparing respective medical reports.

Verification of Billing Invoices, Attachment of medical reports, Reviewing investigation reports, pharmacy and lab reports

Reviewing & Cross-verifying CPT and ICD codes before getting approvals.

Deals with the area of Online Approvals.

Obtaining preauthorization for all the required services from concerned Insurance companies by delivering proper medical justifications.

Maintaining good rapport with insurance companies.

Regular and timely follow up on pending issues with the concerned Insurance companies.

To respond satisfactorily to the needs and requirements of the concerned Insurance companies.

Responds to the enquiries about policy coverage and limitations from various outpatient and inpatient departments.

Ability to get verbal and written authorizations to provide treatment in accordance with the procedures and policies.

Reviewing the request if the condition is covered by the insurance.

Coordinating with insurance company doctors to receive authorization letters for different procedures.

Daily follows up with insurance companies for approval, denials and inquires through all medium of conversation: E mails, Tele conversation Faxes online authorized system with full record. Verifying the each bills of insurance with claim form and patient card copy in timely manner.

Solving patient's problem. Multi-tasker. Performing any Job/Tasks as and when assigns by the manager. Reporting daily approval and denial to insurance manager.

Reassessing cases upon submission and re submission contacting with insurance for assuring the approvals.

Saving approval details in Sage Accpac software. Preauthorization, Medical Coding & Billing Professional Saudi German Hospital, Dubai

Roles & Responsibilities:

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

• Responsible for filing and tracking insurance claims and informing patients of their claims status.

• Process insurance and disability claims in a timely manner.

• Prepares insurance forms and associated correspondences.

• Entertains patients’ queries regarding unpaid balances.

• Maintains strict confidentiality related to medical records and other data.

• Assists in the planning and organizing of the Insurance.

• Attaching, filing, and checking of manual claims.

• E-claim correction and claiming of new quotes if not present in the price list.

• provide general administrative and clerical support including mailing, scanning, faxing and copying to management

• Follow-ups to different departments, company, person any pending documents as requested by the Manager including the status thereof.

Saudi German Hospital, Dubai

Roles & Responsibilities:

High level Customer/Patient relations and attendance

Serving as Team Lead in reservation department

Schedule appointments effectively by maintaining a ‘Real-time Calendar System’ in organizing and setting-up of patient appointments tailored to its need, suited to the most appropriate time and Doctor’s availability.

Encoding and everyday update of ‘Patient Record Database’, based on Doctor’s diagnosis.

Maintain company files & data archiving of client confidential files.

Patient checked-in and out, and registration in the electronic health record system.

Confirmed and input insurance and demographic information.

Provided initial patient/clinic contact.

Answered multi-line phone system.

Clinic traffic control and data entry.

Greet patients and families in a professional manner.

Ensured positive and professional first impression of the clinic.

Performed receptionist duties and provides clerical support for the clinic.

Triaged patient telephone calls to clinical staff; obtain necessary information for the return call; initiate emergency procedure when necessary.

Maintained pleasant atmosphere in waiting areas. Preauthorization, Medical Coding & Billing Professional

Advocated for the patient/family by locating appropriate staff to address concerns.

Communicates and enforces billing and payment policies of the clinic.

Collected payments.

Other duties as assigned.

Posted non-patient ledger payments.

Made discount adjustments.

Dispersed patient record upon check-out.

Balanced cash at the close of the shift.

Managed safe deposit boxes.

Dental Professional Hospital, Pakistan

Roles & Responsibilities:

Passing requested instruments to the dentist during dental procedures.

Sterilization and preparation of instruments.

Taking impressions of teeth for study models.

Polishing clinical crowns.

Exposing and developing X-rays.

Providing assistance in the office with tasks such as appointment scheduling, record keeping, telephone management, and billing.

Ordering supplies.

Served as office manager or receptionist, greeting patients and introducing patients to the dental practice.

Managed the business aspect of dentistry including bookkeeping, accounting, and money management

Managed patient records, filing, and recall systems.

Assisted the dentist directly at chair side with operative, oral surgery, orthodontic, and a wide range of other procedures.

Provided oral hygiene instructions, preventive dentistry & dietary counseling.

X-rays, impressions, and apply fluoride and sealants.

Assisted with patient management by working with a wide range of population groups.

Performed laboratory functions such as pouring & trimming models, constructing custom trays and fabricating temporary crowns and bridges.

Assisted with implementation and documentation of current infection control standards.



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