DR RONEET SHAHZAD

RCM Coordinator

PROFILE

An incisive professional with 7 years

of experience in Revenue Cycle

Management and Medical Audit in

UAE.

Proficient with Insurance,

Reimbursement concepts and

Denial Management.

Hands on experience in

eClaim submissions and

resubmissions.

Excellent relationship management

skills and efficiency in dealing with

clients across the industries.

Ability to lead, mentor and motivate

the team. Keen planner and

strategist with a detailed oriented

approach.

Excellent Interpersonal and

presentation skills.

Resourceful at evolving effective

procedures, establishing services

standards and operational policies

with proven ability in reducing

disallowances through effective

operational measures.

CONTACT

PHONE:

+971*********

EMAIL:

adlgf9@r.postjobfree.com

PERSONAL INFORMATION

Visa Status: UAE Residence Visa

Marital Status: Married

Valid UAE Driving License

WORK EXPERIENCE

Mediclinic Welcare Hospital, Dubai - UAE

RCM Coordinator

November 2014 – Present

Medical Reconciliation - following up with the payers to close the financial year, annual recon report, meeting with payers to discuss claim by claim.

Denial Management - Orientation for newly joined doctors (eclaim work flow and coding/ Insurance guidelines)

Analyzing the denied claim and making sure that it is resubmitted accurately as per denial reason, ensuring that diagnosis and CPT codes are updated wherever necessary and proper justification and supporting documents were given.

Participating in Clinical Documentation Improvement program.

Case Management – Coordinating with Insurance team and payers to sort out daily issues at submission and resubmission levels.

Conducting Internal and External Audits

Allocating disallowed amounts as per standard procedure.

Monthly generation of statements from the system

Maintain database of processed claims.

Auditing of RCM team on a monthly basis for potential errors and guiding and coordinating with submission and resubmission team to reduce these errors from coding and technical point

Understanding DHPO schema and sorting out uploading errors

Actively involved in Utilization review committee. Monthly meeting with insurance, billing team, doctors to control medical and technical errors.

Problem Solving and Decision Making for Dispatch/resubmission and Billing

Staff training

Input during performance management process.

Participation in Quality Improvement projects.

Tracking under dispatch cases due to Billing and approval issues Al Zahra Private Hospital, Sharjah - UAE

Medical Insurance Officer

July 2012 – October 2014

Medical Reconciliation and Resubmission

Obtaining Pre-approvals as per the agreed tariff.

Sorting out daily under dispatch cases pending due to pre-approval

Participating in external Audits

Training Doctors and nurses about Insurance protocols and work flow.

Coordinating with staff to dispatch bills within stipulated period to insurance companies.

Instrumental in reducing rejections and recovery by the Insurance companies and facilitating training to billing & physicians on intricacies of insurance submissions, codes,non-covered diagnosis and procedures to minimize claim rejections

Training front office staff

Dental Studio (DENTAL CLINIC), Karachi - Pakistan

General Dental Practitioner

JULY 2008 – AUGUST 2011

Worked as a dentist at a dental clinic named Dental Studio

Dental Treatment in Operative, Periodontics, Endodontics and surgical procedures.

Clinic Administration.

Community trips i.e. School & College visits and presentations.

Procedures i.e. Scaling and Polishing, Tooth Filling, Single rooted root canal treatment, Extractions.

Managing Marketing policies of the clinic.

Managing Patient data base.

Patient education and follow up.

Managing Accounts of the clinic

Altamash Institute of Dental Medicine, Karachi - Pakistan House Officer

APRIL 2008 – MARCH 2009

Worked in Periodontics, Diagnosis, Operative, Orthodontics, Prosthetic and Oral Surgery.

1 year internship as a dentist at Altamash Dental Hospital. Glaxo Smith Kline, Karachi-Pakistan

Dental Marketing Executive

JULY 2007 – APRIL 2008

Organized and represented GSK in several events.

Marketing of the oral health products.

Field trips in School and Colleges

Spreading awareness about oral health

Attended and participated in Annual Sales conferences EDUCATION

Bachelors in Dental Surgery (BDS)

Altamash Institute of Dental Medicine, Karachi - Pakistan 2001-2008

Medical Coding Course

e-Triage Institute, Dubai-UAE

Oct-Dec 2018

Preparing for CPC Exam

In-house Coding Training

Al-Zahra Hospital Sharjah (Al Talouq Coding Institute) Sept 2014

LANGUAGES

English

Hindi/Urdu

REFERENCES

Available upon request

Contact this candidate