Medical Insurance

Mark Fidai

Experience in managing; implementations of healthcare information and EMR systems. Gathering, analyzing and defining business and functional requirements; trend charts and other decision-making tools; workflows and technology solutions for healthcare systems and networks. Proven ability to lead seamless implementations and deliver next-generation technical solutions improving revenues, margins and workplace productivity.

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QUALIFICATION SUMMARY

• In-depth knowledge of Allscripts, NextGen, Medisoft (McKesson), American Medical Software, MS Office and Quick Book

• In the process of completing EMR Certification.

• Major Software/Systems Implementations

• Data Flow & Process Mapping

• Healthcare Practice Management

• Successfully installed and implemented an Electronic Medical Record System

• Completed Medical Coding Professional

• Current member of AAPC, American Academy of Professional Coders

• Certified Medical Biller

• Experienced in CPT and ICD9 coding for six years

• Proficient in billing and claims resolution, Medicare, Medicaid, Third Party Admin., COBRA, Workers Comp

• Full cycle Medical Biller.

• Experienced of Business Operations

PROFESSIONAL EXPERIENCE

Medical Biller November 2010 – Present

Mount Sinai Hospital

• Primary Care, Orthopedic and ENT billing and coding

• Posting Claims

• Verifying and updating patient insurance information

• Trained office staff on scanning documents, refilling faxes, and sending messages to medical staff to help their office become a “paperless” environment

Medical Coder and Biller (Part-time) November 2009 – Present

Prime Health Associates (Primary Care)

• Data entry

• Preparation and billing electronic, paper and secondary claims

• Account representative / collections for resolution of delinquent claims and patient account balances

• Prepare monthly reports and send statements to patients

• Return patients and insurance phone calls

• Checking patients insurance eligibility

• Responsible for the development and ongoing updates of a detailed curriculum for the scheduling, charting, billing, and scanning modules

• Increased internal revenues through ad-hoc analyses of payer and clearinghouse denials

• Helped physicians customize templates to create professional visit notes, captured ICD and CPT codes and linked necessary patient education documents

• Helped create managed care contracts and fee schedules

• Trained office staff on scanning documents, refilling faxes, and sending messages to medical staff to help their office become a “paperless” environment

Medical Coder and Biller (Part time) Jan 2006 – Present

Avesena Home Health Care

• Manage all aspects of medical billing and coding to insurance and patients, including generating HCPCS codes and ICD-9 codes, follow up for unpaid and denied claims, negotiating payment plans for uninsured patients

• Prepare monthly reports

• Send statements to patients

• Return patients and insurance phone calls

• Home health credentialing for insurances

Medical Coder and Biller February 2008 – October 2010

Fidai Medical Group (Primary Care)

• Conducted on-site training for MD, staff and led ongoing webinars to improve efficiencies and cash flow for our office

• Responsible for the development and ongoing updates of a detailed curriculum for the scheduling, charting, billing, and scanning modules

• Increased internal revenues through ad-hoc analyses of payer and clearinghouse denials

• Helped physicians customize templates to create professional visit notes, captured ICD and CPT codes and linked necessary patient education documents

• Helped create managed care contracts and fee schedules

• Trained office staff on scanning documents, refilling faxes, and sending messages to medical staff to help their office become a “paperless” environment

• Preparation and billing electronic, paper and secondary claims

• Account representative / collections for resolution of delinquent claims and patient account balances

• Prepared monthly reports

• Sent statements to patients

• Returned patients and insurance phone calls

• Successfully installed and implemented an Electronic Medical Record System

EDUCATION

Completed Medical Coding Professional, Certified Medical Biller

Masters in Sales/Marketing Karachi, Pakistan

Institute of Marketing Management

Bachelor of Commerce (Major in Accounting) Karachi, Pakistan

University of Karachi

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