Ms Office

Medical Anoud

PBM

Anaya

Medical Claim Analyst –Medical Claims Q Life and Medical Insurance Company

(QLM) Doha, Qatar / from Jan 2017 Still working (4 Years) Occupational Health Registered Nurse Tristar Transport & Construction Company Abudhabi, UAE / from Jul 2014 – Aug 2016 (2 Years) Staff Nurse Saudi Medical Services (SMS) Hajjah, Republic of Yemen / from Feb 2011-Feb 2013 (2 Years)

Staff Nurse S P M M Hospital Tamil Nadu, India / from Sep 2009 - Dec 2010 Staff Nurse S K S Hospital Tamil Nadu, India / from Sep 2007- Aug 2009 Skills

Med DHA RN

Mr. Rameesh Peppathy Ebrahim

Medical Claims Processor (Claims analyst officer)

Certified Medical Coder (CPC) Registered Nurse DHA Certified medical coder experienced in medical claims and Registered Nurse DHA with Skills, looking for opportunities in Healthcare / Medical insurance adjrty@r.postjobfree.com

+974******** Qatar

+919********* India

Peppathy house

Nellikuzhi Post

Kothamangalam

Ernakulam Dist

Kerala

686691

Date of birth : 27/09/1986

Indian

Language

English

Hindi

Arabic

Malayalam

Tamil

Driving License

UAE

Qatar

India

Interest

Playing football

Playing cricket

Travelling

Certified Professional Coding American Academy of Professional Coders (AAPC)

(Member ID: 01398310) June 2015

Trained Medical Coding and Billing expert in FIMC-AM (ICD-10 AM)

(Fellowship In Medical Coding Australian Modification ) Diploma in Nursing and Midwifery Sri Krishna School of Nursing Bangalore,Karnataka,India from 2004-2007

Higher secondary Examination Mar Basil Higher Secondary School Ernakulam, Kerala, India / March 2004

Secondary School Leaving Certificate Mar Basil Higher Secondary School Ernakulam, Kerala, India / March 2002

Education

Medical Claims Processing Anatomy

Denial Management ICD-9-CM

Direct Billing ICD-10-CM

Re-Imbursement ICD-10-AM

Prior Approvals CPT®

Medical Terminologies HCPCS

Computer Skills

Professional Experiences

Staff Nurse

Measure patient vital signs

Emergency patients care

MI, fractures, accidents

Burns, poisoning, convulsion

Fall downs, shocks, chest pain

Abdominal trauma, etc.

Assisting for Open Heart Surgery

All types of Heart surgeries

First aid treatments

Patient’s medical record

Lists Special Equipments –

Handled

Ventilator

Sphygmomano meter (BP)

Defibrillator

Nebulization Machine

Invasive monitor

Pulse Oximeter

Glucometer

ECG Machine

Suction Machine etc.

Linked In

@ Rameesh Ebrahim

Evaluating, validating and subsequent processing of medical claims as per the corresponding policy manual

Coding the diagnosis pertaining to the claims, as per the ICD10 AM Standards

Addressing the queries related to the claims from corporate clients and individuals, with proper follow up

Educating the corporate clients and individuals about the proper usage of policy benefits

Working knowledge of medical, accounts receivable,collections,rejects denials, appeals, and research billing guidelines and policies

Demonstrated knowledge of CPT, CDT, ICD-9/ICD-10 and HCPCS

Review outstanding claims to determine what action needs to take place and make status calls to insurance companies

Request claims to be reprocessed where necessary or prepare and submit corrected claims to the insurance companies for payment

Review delinquent accounts and initiate appropriate collection action including telephone calls and correspondence to patients

Answer patient calls relating to questions about their bills

Update demographic and payer related information obtained from the Patients

May correct errors including misapplied payments/adjustments and applying account credits

Prepare refund requests for management approval

Responsible for the generation and mailing of claims

Work payer rejects and denials

Support and train site checkout staff

Support management on special projects

Maintain a high level of customer satisfaction as reflected on patient satisfaction surveys and other measurement tools

Additional Duties and Responsibilities

Additional duties as requested or assigned

Job Profile

Contact this candidate