MOBILE : +971529907200, 0501562109
Dedicated professional with 3years and of experience in the field of medical insurance claims and approvals with consistent track record and proven capability to work in fast paced work environment.
SKILLS & EXPERTISE
· CLAIMS MANAGEMENT · QUALITY ASSURANCE · FILING · COMMUNICATION SKILLS · DATA ANALYSIS · PRESENTATION SKILLS · CLAIMS AUDITING · LEADERSHIP SKILLS
ORGANIZATION ROLE TENURE Ø ASTER DM HEALTHCARE DUBAI Ø E-CLAIMSUBMISSION COORDINATOR , PRE-APPROVAL OFFICER,CLAIMS OFFICER AUG 2015 – TILL DATE Ø APOLLO HOSPITALS INDIA Ø STAFF NURSE MAY 2011 – OCT 2014
ASTER DM HEALTHCARE
DESIGNATION: CLAIMS OFFICER DEP: INSURANCE DURATION: AUG 2015 - PRESENT
- Responsible to manage insurance claims from patients and to analyze and process the insurance claim, checking it for validity.
- Responsible to check and decide if person’s insurance policy covers a particular medical procedure.
- Obtain approvals from the concerned insurance companies for patients when required. Obtaining instant verbal pre-authorization code for services.
- Reviewing bills and statements as per the medical necessity requirements before sending out to insurance companies to reduce risks of denial.
- Review the outpatient list to ensure proper approval status on a daily basis.
- Procuring and sending all the required documents (Cost estimates, pre-approval request form, medical report, investigation results etc.) while requesting for pre-authorization from insurance companies through fax, email or uploading in the online system.
- Review and distribute the pre-approvals to concerned departments on regular basis and without delay.
- To maintain & update a pre-approval log with requests’ details, the date and time at which they were received from each department, communicated to Insurance companies, approvals/denials/queries received, and distributed to the concerned departments.
QUALIFICATION YEAR PASSED INSTITUTION SECONDARY SCHOOL LEAVING CERTIFICATE 2004 S.H.M.H.S.S. TAMIL NADU,INDIA HIGHER SECONDARY SCHOOL LEAVING CERTIFICATE 2004-2006 S.H.M.H.S.S. TAMIL NADU,INDIA B.SC IN NURSING 2006-2010 MIRANDA COLLEGE OF NURSING, KARNATAKA ,INDIA
- Proficient in MS Office applications
- Proficiency in computer applications
- Good Typing Speed
CLINICAL EXPERIENCE IN DETAIL
Working in the Nursing Services of Apollo Hospitals, Chennai – 6 (Multi-Specialty with 610+ beds), as a Staff Nurse in Emergency Medical Services from 26/05/2011 to 22nd OCT 2014
DESCRIPTION OF THE HOSPITAL
Apollo Hospitals Chennai is 610+ bed multispecialty tertiary care centre that which has over 50 medical and surgical disciplines with specific areas of interest in specialties like Emergency, cardiology, cardiothoracic, nephrology, midwifery, neonatal ICU including critical care, recovery, operation theatre. This hospital is a tertiary centre in South East Asia. It is India’s first co-operative multispecialty hospital and one of the first hospitals to an ISO certificate in the region and Asia’s first JCI accredited hospital.
AHA approved CPR Training Courses
- Nationality: INDIAN
- Passport : J9695021
- Date of Birth: 12th may 1988
- Place of Birth: kanyakumari
- Marital Status: Single
- Languages: English, Hindi, Malayalam, Tamil
I hereby declare that the above written particulars are true to the best of my knowledge and belief. I will be held responsible for any deviation from the above mentioned details
|Last Resume Update||September 25, 2018|
|Address||DUBAI, United Arab Emirates|