SAP
Asfaq Muhammed Hussain
Revenue Cycle Management/Healthcare/Operation/Project Management
Palakkad,Kerala
Summary
- A professional with Revenue cycle management/Operational experience with 12 + years in the UAE healthcare industry dealing with healthcare operations & Denial management experience.
- Talented leader with analytical approach to business planning and day-to-day problem-solving and offering history of success coordinating and monitoring operations across Internal and External stakeholder.
- As a effective leader and problem-solver dedicated to streamlining operations and promote organizational efficiency.
- Highly committed with hardworking mentality to maintain and achieve organizational goals.
Overview
1
1
Language
7
7
years of post-secondary education
13
13
years of professional experience
Work History
Manager
VPS Healthcare
Abudhabi, UAE
10.2018 - Current
- Managing a large Group (20+ Facility) planning and monitoring and ensuring revenue generation by submitting/Resubmitting maximum number of claims as per DOH policy.
- Responsible for new project implementation.
- Establishing and implementing new departmental revenue cycle processes based on DOH/DHA/Insurance Company.
- Ensuring data accuracy accountability for divisional financial performance, charging methodologies and capture, and revenue enhancements.
- Effective development, implementation, monitoring and communications of goals, objectives, budgets and expected performance outcomes.
- Analyzed critical operations on an ongoing basis, and developed reports that evaluated and demonstrated productivity and performance gains.
- Providing instruction, finding Root cause and Forecast leadership, and supervision for team with large group of employee.
Assistant Manager
VPS Healthcare
Abudhabi, UAE
07.2017 - 09.2018
- Managing Denial management department.
- Identify the trends external and internal stakeholders in denials and implement resolution measures.
- Monitoring the RA and trends and ensure the timely resubmission with agreed TAT.
- Communicating with insurance companies regarding wrong /Incorrect denials.
- Training and education for common error which identified on root cause analysis to internal stakeholder’s/Department.
- Coordinated efforts across all departments to decrease billing errors and increased revenue, working closely with stakeholders POC (Insurance Manager/Billing Manger) determine opportunities for improvement and revenue recovery.
Senior Associate-Denial Management
Accumed Practice Management
Dubai, UAE
05.2016 - 06.2017
- Creating automated & integrated Revenue cycle flow process.
Process improvement to reduce claim denial rates identified through reconciliation. - Expert in denial analysis report and re submission recovery rates review.
- Experience in providing Internal and external stakeholder training to ensure process flow for better results.
- Identify market trends through analysis based on common rejection by Payers.
Medical Auditor-Revenue Cycle Management
Accumed Practice Management
Dubai, UAE
11.2014 - 04.2016
- Evaluates and ensures that all claims denied or underpaid inappropriately by payers are identified, appealed and reversed.
- Maintain production goals and quality standards set by the audit for the auditing concept. Audits against the standard expected level of quality and quantity.
- Monitoring and analysis of claims submitted monthly/Daily to DHA/HAAD portal.
- Handling special projects from external provider and internal departments.
Medical Claim Processor
National Health Insurance company- Daman
Abudhabi, UAE
08.2010 - 11.2014
- Evaluate medical necessity and correlates consistencies in the diagnosis, procedure and drugs stated on the claim, according to medical coding rules and medical guidelines.
- Processes claim payment ensuring accurate application of agreed discounts benefit schedules with providers, correct allocation of benefits, collection of deductibles,co-pays,co-insurance,observance of policy limits, and adherence to claims submission protocols.
- Gives regularly provider observation to improve the quality of provider claims.
INSURANCE CO-ORDINATOR
VPS Healthcare
Abudhabi, UAE
01.2009 - 07.2010
- Comprehensive experience in interacting with insurance companies, patients and end-users.
- To review and audit the e-claims and paper claims before submission to the insurance company.
- Experience with medical insurance applications such as claims processing and Revenue calculation.
HOSPITAL PHARMACIST
FATHIMA SUPER SPECIALITY HOSPITAL
Calicut, Kerela
10.2007 - 12.2008
- Provide specialized pharmaceutical services to improve drug usage
- Patient counseling regarding patient with chronic illness
- Advising physicians on issues concerning drug therapy and inherent toxicity of drugs and their side effects, and assisting in the prescription of appropriate doses.
Education
Bachelor of Science - Bachelor of Pharmacy (BPharm)
09.2003 - 09.2007
MBA - Hospital And Health Care Facilities Administration
01.2014 - 12.2015
Certification Course - Medical Insurance Coding
04.2014 - 04.2015
Certification Course - Lean Six Sigma
05.2021 - 08.2021
Currently am Pursuing the Lean Six Sigma Black Belt course and certification will complete by Aug'2021.
Skills
Project Management
Accomplishments
- Successfully Implemented Automation Process in claim processing which given organization high level reduction in administrative cost/Manpower.
- Successfully Implemented pharmaceutical adjudication guideline to MSD department in Daman national health insurance ans won recognition from Management for Best guideline.
- Selected as a team member for drug formulary preparation by Daman for HAAD regulation Project.
Software
INSTA
SAGE ACCEPAC
Additional Information
- Training certification for coding guideline
- Completed training in inter personal communication skills.
Timeline
Henry Harvin - Certification Course, Lean Six Sigma
05.2021 - 08.2021
Manager - VPS Healthcare
10.2018 - Current
Assistant Manager - VPS Healthcare
07.2017 - 09.2018
Senior Associate-Denial Management - Accumed Practice Management
05.2016 - 06.2017
Medical Auditor-Revenue Cycle Management - Accumed Practice Management
11.2014 - 04.2016
ANGEL CODING ACADEMY - Certification Course, Medical Insurance Coding
04.2014 - 04.2015
Assam Down Town University - MBA, Hospital And Health Care Facilities Administration
01.2014 - 12.2015
Medical Claim Processor - National Health Insurance company- Daman
08.2010 - 11.2014
INSURANCE CO-ORDINATOR - VPS Healthcare
01.2009 - 07.2010
HOSPITAL PHARMACIST - FATHIMA SUPER SPECIALITY HOSPITAL
10.2007 - 12.2008
PSG Institute of Medical Science - Bachelor of Science, Bachelor of Pharmacy (BPharm)
09.2003 - 09.2007
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