Undewriting Manager
Amana Cooperative Insurance Company
Total years of experience :14 years, 8 Months
Technical head of medical department, responsible for profitable growth of the medical business with efficient risk assessment
▪ Adeptly administered medical insurance underwriting and operations, including claims and policy administration as well. Successfully managing smooth operations of all functions of medical department
▪ Capably handling reporting to senior management with production, claims and policy performance reports on required basis. Proficiently maintained turned around time defined in service level agreement
Answer calls from physician offices, hospitals, and patients using exemplary customer service skills.
Accurately enter required information (non-clinical and structured clinical data) into computer database.
Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes (without the need for interpretation) and follow established procedures for authorizing request or referring request for further review.
Attach incoming information to I Care database and follow established procedures for distributing information for further review.
Call hospitals for discharge dates as needed.
Refer callers to benefit departments of correct claims administrator when requesting benefit information.
Maintain patient confidentiality as defined by state, federal and company regulations.
Establish effective rapport with other employees, professional support service staff, customers, clients, patients, families, and physicians.
Actively support departmental and corporate strategic plans and ensure successful implementation.
Decoding Approval by utilizing WHO certified ICD 10 System
Healthcare Management
Completed Healthcare Antifraud Associate (HCAFA). Subjects Healthcare Fraud Part 1 & 2 Medical Identity Theft Webinar New areas of legal Risk
Healthcare Management
Heatlcare Customer Service Strategies
Completed Health Insurance Associate (HIA) from American Health Insurance Plan (AHIP)
Requirements Insurance Legal and Regularity (IF1) Health products (IF7) Private Medical Insurance (P64)
I am holding IFCE (Insurance foundation cetificate Exam),
