MOHAMMED RAFI
MEDICAL CODER INSURANCE COORDINATOR
ABU DHABI
Summary of Career
1. 4 years Medical Coding experience with Bachelor degree in Pharmacy
2. Well Handled 11 different clinics of DHA and HAAD -Submitting Medical bills to the insurance companies for claim reimbursement -3 YEARS EXPERIENCE IN INSURANCE COORDINATOR -HANDLED PRE-APPROVALS/PRE-AUTHORIZATION, ELIGIBILITY AND RE SUBMISSION OF CLAIMS TO INSURANCES
3. HANDLING AND SOLVING QUERIES RELATED TO APPROVALS/CODING WITH DOCTORS AND INSURANCES -Assign ICD10 CM Diagnosis codes, CPT4, and HCPCS codes per HAAD / DHA Guidelines, and other coding conventions
4. Assign the appropriate Evaluation & Management codes -Documentation, Coding, Auditing, Denial coding, Resubmissions and Submissions -CODING AND APPROVALS IN BOTH GP, SP AND DENTAL
5. aintaining Weekly and Monthly Client reports of revenue Cycle. -Soft wares- SHADE, MEDIWARE and INSTA soft wares, E-claims Link software -MS excel handling
6. Experience in DHPO, Eclaims,submisison,, claims and rejection, denial management. -Coordinate with insurance companies for getting daily authorizations and network issues
7. -Manage the overall medical hospital insurance claims, approval, procedures, denials and receivables. -Obtaining approvals for medical procedures, - Experience approvals and pre-authorization, queries with physician, and managing follow up and documentation for dental
8. Experienced in JAWDA TASNEEF audit
9. omplete understanding of HAAD Claim Adjudication rule,Generating XML FILE submitting claims in HAAD post office -Query Physician for clarification and additional documentation prior to code assignment
10. experience in processing insurance for pre-approval, claims submission and re-submission -WORKED IN NMC ROYAL FOR BACKLOG PROCESS
AHIMA
Experience as SENIOR MEDICAL CODER
01 January 2019
30 September 2019
• PRE-APPROVALS/PRE-AUTHORIZATION
• Documentation, Coding, Auditing, Pre-approvals, Denial coding, Resubmissions and Submissions.
• Doctor documentation training
• Coding with HAAD Claim Adjudication rule, Generating XML FILE submitting claims in HAAD post office
• Handled JAWDA TASNEEF audit for the clinic
Experience as MEDICAL CODER
01 December 2017
20 December 2018
• Handled 8 different medical centres in Dubai and Abu Dhabi
• Coding, Auditing, Denial coding, Resubmissions and Submissions for DHA and HAAD
• Maintaining Weekly and Monthly Client reports of revenue Cycle.
• Soft wares- SHADE, MEDIWARE and INSTA, Eclaims, DHPO Link
• Client Preparation for TASNEEF audit passed with 97%
• Experience in DHPO, E-claims, submission, claims and rejection, denial management.
• WORKED IN NMC ROYAL FOR BACKLOG PROCESS
• handled a team of 4 in coding processes
Experience as JUNIOR MEDICAL CODER
03 November 2015
22 November 2017
• US coding with multiple clients, Daily Production of 20 to 25 charts
• HCC coder with efficiency of 95%
Bachelor 09 June 2015
BACHELOR IN PHARMACY