DR.MALLIKA . C

Email:adngem@r.postjobfree.com

Mob: +91-807*******

JOB OBJECTIVE

To attain a state of physical perfection at work, providing mental satisfaction to patients, and maintaining peace and harmony at work with my expertise and hard work. Keen towards a calm working environment with good technological equipment to assist the daily dental procedures.

Profile Summary:

16 years of work experience, in highly professional standards. 9 years of experience as dental surgeon in India.

7 years of experience as Insurance coordinator/Medical auditor/IP resubmission analyst in UAE.

Passionate about educating patients on importance of oral hygiene.

Committed to providing the best patient care through communication and high quality service.

Proven record of reliability and responsibility.

Remain calm and professional throughout critical incidents.

Devoted to remaining update on the latest techniques to provide the highest level of patient care.

Strong analytical skills, capable of assessing conditions and implementing appropriate Intervention. Professional Experience:

Dental Surgeon Experience

Dentaris Dental Clinic, Trivandrum, Kerala from January 2020 to March 2021.

Snehadeepam hospital, Neyyattinkara, Kerala from June 2010 to March 2011

Smile styler’s dental clinic and implant Centre, Trivandrum, kerala from August 2008 to December 2009.

Travancore dental clinic,Trivandrum, kerala from February 2005 to March 2008.

Cosmetic dental clinic, Harippadu,Kerala, India from February 2002 to November 2004

Thomas memorial dental clinic, Mannar, Kerala, India from February 2001 to January 2002. TRANSCITI Solutions Kerala, India /Oct 2020 – Dec 2020 Designation: Medical Coding Tutor

Proficient in training domain as Medical Coding Tutor.

End to end training in Medical Billing Process, which involves removing information from documentation, assigning most appropriate codes, creating claim sheet to be paid by Insurance carriers.

Reviews and verifies documentation support diagnosis, procedures and procedural information. Medical Auditor/Coder/ Insurance Coordinator

1. Burjeel Hospital Abu Dhabi, UAE /Jan 2018- 2019 July Designation: IP Resubmission Analyst

Audits medical record documentation to identify under coded and up coded services; prepares reports of findings and provide vide education and training on accurate coding practices and compliance issues.

Provides second-level review of billing performances to ensure compliance with legal and procedural policies and to ensure optimal reimbursements while adhering to regulations prohibiting unbundling and other questionable practices.

Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services.

Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation.

Ensures strict confidentiality of financial records.

Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.

Performs miscellaneous job-related duties as assigned. 2. New Medical Centre (NMC) Abu Dhabi, UAE /Oct 2015 – 2017 Dec Designation: Medical Auditor

Expertise in Diagnosis Related Grouping.

Work proactively with Manager RCM, Coding staffs, Pre-authorization staffs to develop measures to reduce the number of denials through research of denial trends.

Analyses, categorizes denials based on the root cause findings, and continually improves best practice methodology for denied claims recovery.

Acts as a resource when necessary for billing, pre-authorization and reimbursement issues and coding.

Aware of current trends related to medical necessity, DRG and HAAD Claims and Adjudication rules and coding guidelines.

Applying advanced knowledge of medical terminology, anatomy and physiology, treatment modalities, diagnostic test, medications.

Providing orientation and education to coders, pre-authorization co-coordinators, physicians and nurses based on Rejection Analysis.

Excellent interpersonal skills while interacting with physicians, nurses and other staffs. Ensure high level of patient data confidentiality.

3. New Medical Centre (NMC) Abu Dhabi, UAE /Jan 2012 – Oct 2015 Designation: Senior Insurance Coordinator

Coordinating with doctors for preparing medical report.

Submission of claims to different insurance companies with all the documents required

Resubmission and reconciliation of rejected claims Maintaining good rapport with insurance companies.

Checking invoices for attachment of medical reports, investigation reports, pharmacy and lab reports.

Checking prescriptions and investigations related to diagnosis.

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

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.

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

Case follows ups, obtaining medical reports and results prior to authorizations. Receiving requests for approvals from various departments for surgeries & other procedures.

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

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

Coordinating with attending doctors for some clarification regarding the condition of the patient.

Coordinating with the nurse whenever the insurance companies need some investigation medical report to be sent for the company’s perusal.

QUALIFICATION:

Bachelor of Dental surgery (B.D.S) from Government Dental College, Trivandrum — 2001, Kerala University, India

Completed one-year compulsory rotatory internship in February 2001.

CPC certification from AAPC in 2019.

Completed PG Diploma in Clinical Research and Pharmacovigilance from Cliniminds, Delhi in 2021. Personal Details:

Date of birth : 29/08/1975

Nationality : Indian

Language known : English, Malayalam, Hindi, Tamil

Marital status : Married

Place: Kerala,Trivandrum

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