Revenue Cycle Speacialist
Hospital Revenue Cycle Specialist
Skilled and Experienced Revenue specialist with strong knowledge of Insurance and medical billing
Successfully implemented Hospital Management System
Highly organized with strong attention to detail
Ability to self-motivate and work with minimal supervision
Hands down knowledge in insurance practices and medical billing interpretations
Strong medical billing history.
Excellent oral and written communication skills.
Excellent team player
· Set up payment plans for different payers
· Liaise with insurance companies and Sports Clubs for finance related issues
· Maintaining robust documentations
· Supervising Account receivables ensuring all aspects are covered
· Reduced rates of denial claims.
· Monitoring Revenue Cycle Management to ensure that targets are always met.
· To ensure timely and accurate insurance billing & club patients billing.
· Timely coordination for patient inquiries regarding billing issues as necessary.
· Working in close coordination with Medical team, commercial and private insurances for claims verification and processing.
· Some of the major MNC insurance, I served for viz., Bupa Middle East, Mednet, Alico, NCCI, Gulf union insurance, Globemed Saudia, Saudi continental insurance, AXA insurance, Allianz Worldwide, Aetna Insurance, Arab Malaysian Takaful insurance, etc., and major Direct companies like ABV Rock, Aramco & other Sports Clubs in Qatar.
Claims Officer – Aspetar, Qatar Orthopaedic and Sports Medicine Hospital
May 2011 – till date
· Invoicing for Local & Internationals patients referred from Clubs or Insurance companies.
· Liaising with different sports club pertaining the treatment and payment mode.
· Coordinating with the 3rd party (insurance) for the approval regarding the patient’s procedure, investigation & payment for the same.
· Maintaining strong follow up with debtors for payments & doctors regarding patient claims.
· Overseeing department training and individual development
· Generate monthly A/R reports for senior management meetings
Accountant and Billing Executive – Fujairah Port Medical Center
September 2007 – May 2011
· Drafting bills for In Patient and Outpatients visiting the Medical Centre.
· Preparing Salaries, Leave salaries and Final settlements.
· Coordinating with the accounts manager regarding various insurance policies relating to company and employees
· Coordinating with the 3rd party (insurance) for the approval regarding the patient’s procedure & investigation.
· Coordinating with debtors for payments, patient’s information and pricing factors.
· Reconciliation of bank statement.
· Coordinating with doctors regarding patients claim
Saudi German Hospital – Aseer (Abha), Saudi Arabia as Billing Officer and Supervisor In charge
June 2003 – July 2007
· Supervisor In charge for Accounts Receivable.
· Training and development of newly recruited staff.
· Discussing policy matters with other department head and making decisions with consensus.
· Monitoring new policies of the companies and concise as per patient queries.
· Maintaining online track with Admission & Discharge office regarding in patient receipt and the cash dealings.
· Coordinating with insurance & non insurance companies for policies, approvals & emergency cases.
· Coordinating with patients regarding their approvals, referral letters, Id, coverage & exclusions under the policy
· Coordinating with Medical Staff for queries regarding patients for approvals, claims etc.
· Preparing invoices according to company’s policies, limits, exclusions, price list & package deal price for the patients from insurance & non insurance companies along with the related documents
OTHER WORK EXPERIENCES
· MGM Hospital, Navi Mumbai, India as Billing Officer / Accounts Assistant from Feb 2000 to June 2003 (Tally Program)
· MGM Hospital’s Medical Store, as Sales / Accounts Assistant from April 1995 to May 1998 Tally Program)
· Has worked for BPL as In Shop Demonstrator” (Marketing) from June 1999 – Jan 2000
· Bachelor of Commerce, Mumbai University, April 1999
· Higher Secondary Certificate (XII–H.S.C) from Pune Board in March 1995
· Passed Secondary School Certificate (X–S.S.C) from Pune Board in March 1993
CAREER AWARDS AND ACHIEVEMENTS
· Awarded as the Best Accountant for the year 2002-2003 in MGM’s New Bombay Hospital
· Appreciation Award for the Best Accountant for the year 2010 in Fujairah National Group
Birth date – 06/01/1976
Nationality – Indian
Marital Status – Married
Residence Status – Permanent
- May 1998 - April 1999
B Com Graduate at Mumbai University
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