Experience

International Radiology Centre

• United Arab Emirates
• Hospitals and Health Care
• 1 - 100 Employee

• Insurance Coordinator

  • Nov 2016 - Present

   Managing and coordinating clinic software applications to the successful clinic operations.  Coordinate, liaise and negotiate with different insurance company with regards to pricing and service agreement to provide better quality services to the insured clients.  Coordinate and communicate all “changes” in respect of insurance policies, plans and pre-approval process.  Handling and swiftly managing day to day settlement of insurance claims.  Responsible for the settlement of corporate bills (HMO & CREDIT COMPANIES).  Creating, monitoring and periodically evaluating the general, corporate and insurance tariffs in line with subgroups and networks.  Follow-up outstanding accounts from insurance companies and ensure collections are collected in a timely and accurate manner.  Tracking the receivables from the insurance companies and do re-submission to ensure the payments.  Allocate payments received from insurance companies for each claims.  Prepare monthly insurance receivable reports and update account records.  Communicating with all Insurance companies for empanelment, addition of new services, doctor’s code, consultations, price list, pre-authorization queries etc.  Preparing MIS and follow up with all the Insurance Cos. for outstanding payments.  Attend regular meetings with the Network Managers of Insurance Companies as required for empanelment, insurance reclaims and other related matters.  Reduced the rejection rate to less than 5%.  Monitor non-batched/non submitted claims regularly.  Monitor Insurance rejection percentage and to take measures/develop guidelines and suggestions to control the same.  Responsible for giving comprehensive training for the employees on healthcare eclaiming and associated softwares.  Resolve any problems with patients, doctors and Health Insurance Companies.  To be constantly in communication with doctors, receptions and various departments.  Perform other related duties as assigned.



Shanghai Medical Center

• Dubai

• Sr. Insurance Coordinator

  • Jan 2015 - Nov 2016

   Managing and coordinating clinic software applications to the successful clinic operations.  Coordinate, liaise and negotiate with different insurance company with regards to pricing and service agreement to provide better quality services to the insured clients.  Coordinate and communicate all “changes” in respect of insurance policies, plans and pre-approval process.  Handling and swiftly managing day to day settlement of insurance claims.  Responsible for the settlement of corporate bills (HMO & CREDIT COMPANIES).  Creating, monitoring and periodically evaluating the general, corporate and insurance tariffs in line with subgroups and networks.  Follow-up outstanding accounts from insurance companies and ensure collections are collected in a timely and accurate manner.  Tracking the receivables from the insurance companies and do re-submission to ensure the payments.  Allocate payments received from insurance companies for each claims.  Prepare monthly insurance receivable reports and update account records.  Communicating with all Insurance companies for empanelment, addition of new services, doctor’s code, consultations, price list, pre-authorization queries etc.  Preparing MIS and follow up with all the Insurance Cos. for outstanding payments.  Attend regular meetings with the Network Managers of Insurance Companies as required for empanelment, insurance reclaims and other related matters.  Reduced the rejection rate to less than 5%.  Monitor non-batched/non submitted claims regularly.  Monitor Insurance rejection percentage and to take measures/develop guidelines and suggestions to control the same.  Responsible for giving comprehensive training for the employees on healthcare eclaiming and associated softwares.  Resolve any problems with patients, doctors and Health Insurance Companies.  To be constantly in communication with doctors, receptions and various departments.  Perform other related duties as assigned.



Aster DM Healthcare

• Hospitals and Health Care
• 700 & Above Employee

• Coordinator (Insurance & Software)

  • 2010 - 2013

   Managing and coordinating clinic software applications to the successful clinic operations.  Responsible for giving comprehensive training for newly joined employees on healthcare eclaiming & associated softwares.  Handling & swiftly managing day to day settlement of insurance claims.  Responsible for the settlement of corporate bills (HMO & CREDIT COMPANIES).  Reporting to the Insurance Manager on a daily basis.  Prepare cost estimates mainly for various outpatient cases.  Contact Insurance Companies for verbal approval for necessary cases.  Review and distribute the pre-approvals to concerned departments on regular basis & without delay Identify unusual denials & medical report requests & contact the Insurance companies for further discussion.  Coordinates with external and internal clients for approval-related information.  Distributes Insurance related updates to all concerned areas.  Updates the Insurance Manager about any unusual denials/issues from Insurance companies for further discussion.  Establish and maintain the approvals files for easy access for Dispatch and resubmission team  Develop methods to reduce errors in billings & claims  Full knowledge of insurance activities, Full knowledge of billing & claims process  To give approvals for the patients, Responsible for patient in spot problems solving regarding the pre-authorization & claims payments.  Training of insurance assistants to arrange the claims and submitted & re submitted for unpaid claims.  Deals professionally with customers & provides effective service & Customer satisfaction surveys  Handling independently the Claim, Approval, Administration (Insurance related) including Accounts Dept.  Preparing Claim, Monthly Statement and Outstanding Statement & Processing insurance claims in a timely manner.  Liaising with the patients regarding their eligibility & entitlements.  Professional experience with demonstrated competency including management & leadership skills.



Focuz Corporation Pvt. Ltd

• India

• Accountant

  • Jun 2007 - Jun 2010

   Maintaining and updating the financial records of daily cash and bank transactions and keeping the relevant invoices to substantiate all expenses claimed (Head Office & Branches).  Formulating timely statements and reports of receivable and payable for management.  Physical checking of all issued items and validating the stock register.  Analyzing and reviewing budgets and expenditures for local, central and private funding, contracts and grants.  Monitoring and reviewing accounting and related system reports for accuracy and completeness.  Preparing and maintaining time to time payroll emoluments including salary, wages and allowances.  Concocting MIS reports and generating invoices on time.  Organizing and reviewing of accruals and ensuring reconciliation of Banks, Clients, Branches and Divisions (Sister Concerns).  Preparing retails invoices.  Preparing and maintaining time to time VAT, TDS, Service Tax, PF and ESI.  Conducting internal auditing and recommending implementation for improvements.  Handle manual and computerized accounting up to finalization including Profit & Loss A/c and Balance Sheet.