Insurance Incharge
Al Sultan Modern Medical Hospital
Total years of experience :9 years, 5 Months
In charge of Revenue cycle management.
Complete insurance companies /TPAs network, factors negotiation and establishing network contracts.
Interviewing panel for the post of coders and Insurance coordinators.
Price list preparation.
Training for doctors on E &M, ICD 10 codes, CPT-4 codes and USC&LS codes for the procedures.
Training Insurance staff, Front office staff, nursing staff on eligibility, coverage information and updated guidelines.
Clinical Documentation Training.
Auditing out-patient department claims.
Generating XML files, uploading in Greenrain, submission of claims.
Resubmission of claims and denial management according.
Creation and updating of Insurance and Medical Records policies whenever necessary.
Preparing all logs and documents necessary for Tasneef audits.
Working in compliance with DAMAN, ADNIC, NAS, NEXTCARE, NIG and other insurance company’s patients who are acceptable in Al Sultan.
Identify Abstract and Code patient data, using ICD-10 CM and CPT-4 and other standard classification coding systems.
Assures codes are supported by provider documentation and initiates appropriate queries based upon other clinical documentation for accurate and reliable data collection and reimbursement
Coding Outpatient Medical records according to DoH guidelines.
Covering all aspects of coding Outpatient.
Coordinating with other healthcare professionals regarding coding issues
Protect the security of medical records to ensure that confidentiality is maintained
Identify, Abstract and Code patient data, using ICD-9 CM, ICD-10 CM and CPT and other standard classification coding systems.
Assures codes are supported by provider documentation and initiates appropriate queries based upon other clinical documentation for accurate and reliable data collection and reimbursement
Resubmitting rejected claims to insurance companies.
Coding Outpatient Medical records according to HAAD guidelines.
Covering all aspects of coding Outpatient.
Effectively communicating with department with respect to the Submission Approvals, Revisions.
Denials and Resubmission.
Coordinating with other healthcare professionals regarding coding issues
Protect the security of medical records to ensure that confidentiality is maintained.
Desktop Technician.
Install and configure Hospital software's whenever necessary,
Operating Hospital Social Accounts.
IT Security Adviser to the Computer Engineer.
Review physical inventories periodically.
Maintain stock and consumption records.
Product management, including ordering, receiving, price changes, handling damaged products, and returns.
Team Development, facilitating staff learning training, and development.
Problem solving, handling unusual circumstances.
To understand the customer service principles.
To handle problems and questions to customers.
Basic Computer applications in stores management and materials control.
Ensuring standards for quality and health and safety are met.
Touring the sales floor regularly, talking to colleagues and customers and identifying or resolving urgent issues.
Dealing with sales, as and when required.
Disposes of expired and waste stock according to the current procedure.
Answering an average of 30 calls per day by addressing patients inquiries, solving problems and providing Doctors information.
Welcomes patients and visitors by greeting them, in person or on the telephone; answering or referring inquiries.
Optimizes patient’s satisfaction, provider time, and treatment room utilization by scheduling appointments in person or by telephone.
Keeps patient appointments on schedule by notifying provider of patient’s arrival; reviewing service delivery compared to schedule; reminding provider of service delays.
Comforts patients by anticipating patient’s anxieties; answering patient’s questions; maintaining the reception area or waiting loungue.
Ensures availability of treatment information by filing and retrieving patient records.
Obtains revenue by recording and updating billing information; recording and collecting patient charges; controlling credit extended to patients; filing, collecting, and expediting third-party claims.
Helps patients in distress by responding to emergencies.
Protects patient’s rights by maintaining confidentiality of personal and billing information.
Maintains operations by following policies and procedures; reporting needed changes.
Contributes to team effort by accomplishing related results as needed.
Ongoing.