P.CHANDBASHA

Mail: adn37a@r.postjobfree.com

Contact No: +919********* Address: Bangalore

PROFILE:

Life science graduate with 7+ years of experience in the field of health care industry ranging from patient care Manager and insurance coordinator.

Self-motivated, enthusiastic, and organized 'Patient Care Manager ' and Insurance Coordinator role with over 6+ years of experience in coordinating with various medical personnel, and ensuring quality health-care services for patients. Expertise in supervising patient care staff, implementing performance improvement programs, and giving appropriate instructions. Team player with excellent management and communication skills.

EDUCATION:

•Accomplished Bachelor of Science with specialization as Health Science (Microbiology, Bio Chemistry and Chemistry) in the year 2007 from Sri Venkateswara University (SVU), Tirupati, India scoring 61.78% aggregate marks securing higher second class.

•Certification in Medical coding and Billing (CMCB) Aldos Medical services Pvt Ltd. Bangalore.

Patient care Manager: (Denty’s Health care)

Summary of Responsibilities:

Plan, coordinate and carry out patient care operations.

Address patient requests and needs in a professional manner.

Respond to patient concerns timely and ensure patient satisfaction.

Schedule patient appointments and make reminder calls.

Greet patients and direct them to examination rooms.

Maintain patient medical records up-to-date.

Obtain insurance information from patients, process patient billings, and collect payments.

Collect and maintain patient health, demographic, insurance and financial information.

Develop patient care plan based on Physician’s assessment information.

Suggest process improvements to enhance patient services.

Maintain patient records confidential and secure.

Job Responsibilities:

Perform nurse screening role for registry patients for their visits, allowing for face to face clinical interactions whenever possible (institution of health maintenance check lists)

Coordinate specialty referrals, which involves:

oArranging appointments if parent desires.

oAssuring appropriate records are forwarded

oSend appropriate chart records to specialist

oAssure referral was completed

oAccess records of referral visit and direct referring physician

oMaintain referral log

Communicate with patients/hospitals around hospitalizations and new diagnoses

Communicate the status of hospitalized to the physician on call and enter note in patient's chart

For patients with extended stays, greater than 1 week, make weekly calls to patient

Arrange follow-up care with hospitals; assure data are available.

Take verbal reports on patients being discharged from hospital and direct info to physician who will see patient

Template and write letters authorizing service and equipment for patients

Help maintain printed or online directory of consultants

Log each PCC call to assist with continuity of care, and ultimately, billing for PCC

Develop and maintain patient email directory.

Patient care Manager: (Dr.Batra’s)

Supervised administrative services for the Clinic.

Handled hospitalization for indigents and low-income patients

resolved administration conflicts and issues .Coordinated in providing support services for the Clinic Floor management.

Responsibilities:

Created, developed, submitted for approval attempts to implement organizational policies and procedures

Evaluated existing medical programs and health care services and suggested enhancements implemented for the

Different departments Ensured efficacy of shifts, personnel services and existing policies of health care facility and mobile unit Prepared and collated daily activity reports to monitor progress, and ensure that implementation plans are on-target Improved service levels by conducting reviews and collating customer feedback and altogether analyze facility activities Scheduled staff rounds and assignments Listed, interviewed, evaluated and hired medical staff and monitored if key performance indicators are met .

Patient Care Coordinator: (Global Hospitals) Key roles:

•Responsible for managing/handling OP and IP patients.

•Instructing patients /Care takers about organ transplantation procedure involved from inpatient services to discharge.

•Completing organ Transplantation surgery formalities.

•Inpatient operation services. OP Billing, MOD Duty.

•Outpatient maintenance (resolving queries, attending calls, maintenance of records)

•Health insurance claim document verification.

•Experienced health insurance claim settlement. Daily reporting to Vice president regarding operation issues.

Insurance coordinator and Front office Manager: (6 moths in Arab doctors specialty clinic Sharajah UAE 2019)

•Researched and solved claim and billing issues

•Interfaced with insurance carriers and other healthcare providers

•Assisted patients with eligibility and benefit coverage questions

•Acquired specific CPT and ICD-9 codes to ensure proper treatment and billing of all detailed procedures

•Maintained transaction report for client billing

•Prepared insurance preauthorization forms and associated correspondences.

•Circulated documentation as needed for reviewing.

•Accept the applications for insurance claims.

•Managed filing and tracking insurance claims and informed patients of their claims status.

•Processed insurance and disability claims in a timely manner.

•Handled patient’s queries regarding unpaid balances.

•Check the applications for authenticity, submitted document proofs, etc.

•Meet the insurance claim applicant, and send a team for authenticity check, in case of doubts

•On completion of documentation and authenticity check, send the application for further approval

•Provide complete assistance to the client until the claim is settled and the money is credited in the client's account

•Coordinated, liaised and networked between insurance companies.

•Liaison for client and insurance company including claims processing, analyzing insurance receivables and reports.

•Prepared administrative and functional reports for CFO.

•Provided administrative support to senior-level staff.

Summary of Qualifications:

•Strong accomplished experience in insurance.

•Sound knowledge medical terminology and insurance practices

•Good knowledge of all plans and medical invoices

•Proficient in Computer Programs and applications

•Excellent communication skills and customer service Skills

•Remarkable ability to relate to people from different cultural backgrounds.

TOTAL WORK HISTORY

Insurance coordinator and Front office Manager: (6 months in Arab doctor’s specialty clinic sharajah UAE 2018 to 2019)

Patient care Manager and Insurance coordinator: Sep 2015 to Nov 2018 to Know Denty’s Dental care,

Patient Care Manager: Aug-2014 To June-2015, Dr.Batra’s Homeopathy clinic

Patient Care Coordinator - Business Development Department July 2012 – July 2014 – Global Hospitals and Health City, Chennai, India.

PERSONAL DETAILS:

Name: P. Chand Basha

Sex: Male

Marital Status: Married

Date of Birth: 05 - 03 - 1984

Address: Door No: 7-466,Noor Colony, Kalikiri, Chittoor (Dist) Andhra Pradesh, PIN:517234

Nationality: Indian

Hobbies: Articles reading, Participate Social Activities .

Declaration

I hereby declare that all the details provided above are true to the best of my knowledge.

Place:

Date: (Chandbasha.pattan)

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