DINA RAJU

TEAM LEADER-REVENUE CYCLE MANAGEMENT at HSCS

• United Arab Emirates - Dubai
• My current job since September 2017

ASSOCIATE RECONCILAITION at ACCUMED

• United Arab Emirates - Dubai
• March 2017 to September 2017

INSURANCE IN CHARGE-MEDICAL CODER at WESTERN MEDICAL CENTRE

• United Arab Emirates - Dubai
• February 2013 to March 2017

 Responsible for coordinating and supporting initiatives relative to the RCM (Revenue Cycle Management)
 Determine the insurance policy coverage, including, but not limited to, diagnosis, clinical procedures, investigation, limits of coverage, patient responsibility, pre authorization etc.
 Review claims to make sure that billing requirements are met, and process them for submissions both e-claims and paper based, wherever required.
 Assigns and sequences ICD-10-CM/CPT-4 codes to diagnoses and procedures for documented information.
 Assures the final diagnoses and operative procedures as stated by the physician are valid and complete.
 Review, download and apply remittance advices from DHA portal.
 Analyze report and prepare re submission for insurance companies.
 Minimizes the disallowances / Rejections by setting up adequate checks and controls in the Insurance and Billing process
 Tariffs and contract Management
 Coordinates with the all staff concerned in the Clinic in updating the new insurance protocols to be followed
 Coordinating with healthcare informatics and consulting firms for the updating of different modules, in order to be at par with demanding DHA novelties, regarding e-claims
 Update the front office staff with the information pertaining to medical insurance in a timely manner
Highlights:
 Submission of claims within 10 days from the end of billing month
 Significant decrease in rejection rate
 Streamlined effective billing system for Thiqa Top Up claims
 Generated comprehensive price list for the Centre with unique CPT codes

MEDICAL INSURANCE CO ORDINATOR CUM ADMINISTRATOR at BADR AL SAMAA GROUP OF HOSPITALS AND POLYCLINICS

• Oman - Muscat
• December 2009 to December 2012

 Coordinating, liaising and networking between insurance companies and patients, regarding eligibility, payments, approvals, reconciliation and other requirements
 Supervisor to the insurance executives and clerks.
 Responsible for filing and tracking insurance claims and informing patients of their claims status
 Process insurance claims in a timely manner
 Arrange various CMEs (Continuous Medical Education Programs) for Doctors and Infotainment programs for Insurance Companies to have a smooth and congenial functioning of insurance related matters.
 Manage insurance claims
 Conducting weekly meetings to evaluate the week updates and shortcomings.
 Update and chase delegated tasks to ensure progress to deadlines and coordinate the workflow.
 Train and educate front office staff in insurance matters and act as a back office support for them.
 Design and implement a protocol for insurance practices in the hospital.
 Coordinate and co-operate with colleagues of the same department and other related departments for smooth running of Insurance operations.
Highlights:
 Systematically structured the insurance department of the hospital

Human Resource Consultant at Elixir Web Solutions

• India
• April 2009 to November 2009

Organisation: Elixir Web Solutions, New Delhi
Duration: 3 months (April 2009-July 2009)
Designation: Human Resource Consultant
Scope:
➢ Manpower Planning and Preparation of Job Descriptions.
➢ Managing the Recruitment process from screening to selection
➢ Identifying and sourcing candidates through head hunting, Job portals, database and references.
Short listing prospective candidates for the client interviews.
➢ Conducting preliminary interviews.
➢ Scrutinizing the resumes, interacting with candidates to understand their Capabilities, strengths, limitations
Record keeping of all candidates.
➢ Follow-up the selected as well as interested candidates.
➢ Maintaining the database for the recruitment process.
➢ Negotiate salary with applicant while balancing the clients offered compensation package
Posting various jobs according to client requirement.
➢ Making Reports for monitoring the daily work, weekly work and monthly work schedule.