Huzifa Ahmed

• Processed outpatient claims daily, adhering to medical policies and operational guidelines.
• Reviewed both physical and electronic claims data to ensure accuracy and compliance with operational checklists.
• Maintained an excellent accuracy rate in quality audits, consistently meeting daily processing targets.
• Identified unusual provider patterns and escalated potential fraud to the Supervisor of Medical Claims and Special Investigations
Unit (SIU).
• Participate in departmental training
comprehensive
• Applied ICD-10, CPT, HCPCS, and DRG codes to ensure proper billing and reimbursement.

• Managed outpatient cases across a variety of specialties, conducting history taking, physical exams, and developing treatment
plans.
• Performed minor surgical procedures and followed up with patients for continuity of care. Maintained thorough medical
documentation for insurance claims and billing purposes.

• Led clinical operations, managing medical staff and coordinating patient care to ensure high standards of practice and patient
safety.
• Coordinated with insurance companies for accurate medical claim processing, ensuring correct documentation and coding for
reimbursement.
• Ensured compliance with health insurance regulations, maintained relationships with insurance providers, and facilitated
smooth communication for claims processing.
• Collaborated with finance and billing teams to streamline reimbursement processes, improving revenue cycle efficiency.

• Assisted in diagnosing and treating patients both inpatient and outpatient.
• Provided urgent care in emergency situations, stabilizing patients until senior medical staff arrived.