Aiza Sumayod, Medical Authorization Executive OP

Aiza Sumayod

Medical Authorization Executive OP

Neuron LLC

Location
United Arab Emirates
Education
Bachelor's degree, Nursing
Experience
6 years, 0 Months

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Work Experience

Total years of experience :6 years, 0 Months

Medical Authorization Executive OP at Neuron LLC
  • United Arab Emirates - Dubai
  • August 2016 to November 2016

- Call Center Setting-
Professionally answers inbound calls pertaining to eligbility, co-insurance, deductible and coverage of benefits of insured member.
Assessing & Processing medical claims - dental, optical, maternity & OP cases and provide verbal approval over the phone as well as in e-portal, emails & PBM.

Medical Secretary cum Transcriptionist at Al Zahra PRivate Hospital
  • United Arab Emirates - Dubai
  • December 2012 to August 2016

It is a Private General Hospital with a total capacity of 187 beds, including Royal Suites and VIP
rooms. It offers a variety of services with multiple specialties in an all private room inpatient facility. Our
employees are drawn from around the globe and are well-trained in their respective area of expertise. Our
Out-Patient clinics are set up with highly advanced diagnostic, clinical and state-of-the-art medical
equipment.
Assigned OPD Specialties: Gastroenterology, OB-GYNAE, General Surgery, Psychiatry, Bariatric
Surgery, Oncology & Internal Medicine.
DUTIES & RESPONSIBILITIES
* Transcribes medical dictation by a doctor to provide permanent record of patient care i.e. Operative
reports, discharge summaries, and etc.
* Maintain the general filing system and file all correspondence.
* Generates daily statistics or census for every doctor’s consultation.
* Demonstrates an understanding of the medico-legal implications and responsibilities related to the
transcription of patient records to protect the patient and the hospital.
* Prepare application for sick leave attested by Dubai Health Authority and notify DHA for the infectious
diseases as per Hospital Protocol.
* Release medical records to the patient according to the rules and policy of the hospital.
* Answers incoming telephone calls or emails queries and resolved the issues accurately.
* Operates the designated word processing, dictation and transcription equipment as directed to
complete assignments.
* Perform other duties and tasks within the realm of knowledge and ability as required.

Medical Claims Processor- OP & Reimbursement at Starwell Health Management FZ LLC
  • United Arab Emirates
  • December 2010 to December 2012

Reviewed & made sure that there is no omitted information. Responsible for medical claims OP & Reimbursement processing, completeness of requirements & updating client or insurance companies status of processing.
Answers enquries from different providers on the subject claim, eligibility, covered benefits & approval status.
Do basic accounting at the end of the month for payment to providers of their claims.

Education

Bachelor's degree, Nursing
  • at DR. YANGA’S COLLEGES
  • May 2007

courses: NURSING- REGISTERED NURSE

High school or equivalent,
  • at UNIVERSITY OF REGINA CARMELI
  • January 2003

(SECONDARY LEVEL)

Specialties & Skills

Customer Service
Claims Administration
Secretarial
Administrative
Insurance Claims
ACCOUNTING
ADMINISTRACIÓN DE BENEFICIOS
ADMINISTRATION
ANALYTICAL SKILLS
COMMUNICATION SKILLS
CONSULTING
CUSTOMER RELATIONS
INSURANCE

Languages

English
Expert

Training and Certifications

Medical Coding for ICD-10, CPT & HCPCS (Certificate)
Date Attended:
October 2016