Divya Maneesh, Medical insurance and billing team lead

Divya Maneesh

Medical insurance and billing team lead

Orthocure Medical Centre

Location
United Arab Emirates - Dubai
Education
Master's degree, Educational Psychology
Experience
18 years, 5 months

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Work Experience

Total years of experience :18 years, 5 months

Medical insurance and billing team lead at Orthocure Medical Centre
  • United Arab Emirates - Dubai
  • My current job since November 2015

• Coordinating, liasing and networking between insurance companies regarding eligibility, payments, approvals, reconciliation and other requirements.
• Analyse and examine claim forms and other records to determine insurance coverage on a daily basis in order to reduce rejection to minimum possible.
• Manages to abstract pertinent information from patient records and translates the information into diagnostic and procedural codes in accordance with the clinical coding system followed by Dubai Health Authority.
• Queries Physicians when code assignments are not straight forward or documentation in the record is inadequate.
• Billing insurance claims and enter the data into the eclaim and submitting the claims to the concerned insurance companies/TPAs in a timely manner via DHPO.
• Also manages to do resubmissions in eclaim and handle payment transactions, reconciliations, issuing invoices etc.
• Attend calls and provide support and guidance for clinic staff for any query regarding insurance billing, selection of ICD 10/CPT codes etc.
• Explaining coverage of medical benefits to patients when required.
• Maintaining and updating the latest information, procedure, protocols from the insurance companies and circulating among the group.
• Follow ups with insurance companies/TPA’s for the purpose of policy updates, new contracts, revision in contracts etc and also prepare management analysis and reports.
• Attending seminars and meetings related to eClaims and insurance policies and protocols to ensure implementation of all new requiremets to maintain compliance.
• Supervising, supporting, training and guiding other staffs in the team.
• Evaluating, correcting and approving bills.

Education

Master's degree, Educational Psychology
  • at Suresh Gyan Vihar University
  • January 2025

Pursuing

Higher diploma, CPMA
  • at American Academy of Professional Coders
  • December 2017

CERTIFIED PROFESSIONAL MEDICAL AUDITOR

Higher diploma, CPC
  • at American Academy of Professional coders
  • May 2015

CERTIFIED PROFESSIONAL CODER

Diploma, Six month diploma in medical transcription
  • at Spectramedi, a US based transcription company
  • September 2005

Certificate in Medical Transcription, Spectrum Softech Solutions Pvt., Spectramedi, USA Bachelor of Science in Botany -Vocational Model II (Plant Biotechnology)

Bachelor's degree, BSc Botany - vocational plant biotechnology
  • at Mahatma Gandhi University
  • March 2005

Passed out with high 1st class. Also completed the 2 month job training course in plant tissue cullture.

Specialties & Skills

Administrative Duties
Medical Coding
Medical Billing
Medical Transcription
Medical Terminology
ADMINISTRATIVE TASKS
AUTO INSURANCE
BENEFITS
CARDIOLOGY
CLERICAL
CLIENTS
CORRESPONDENCE
DATABASE

Languages

Hindi
Intermediate
Malayalam
Expert
English
Expert
Tamil
Intermediate

Training and Certifications

Certified professional medical auditor (Certificate)
Date Attended:
December 2017
Diploma in Medical Transcription (Certificate)
Date Attended:
September 2005
Valid Until:
January 9999
Certified Professional Coder (Certificate)
Date Attended:
May 2015
Valid Until:
January 9999
Completed the 2 month training course for plant tissue culture (Certificate)
Date Attended:
April 2004
Valid Until:
January 9999