BrighTree, Medisoft & PrognoCIS
Nawaz Ahmed
AR SME
Mysore
Summary
I have a friendly and conscientious personality. In addition, I have 4.2years of experience in Medical billing as SME(US process) Very much focused and result oriented. Worked/learned under difficult situations on how results can be driven even when it's not possible. US Healthcare RCM Professional with 4.2years of extensive experience and knowledge in Physician, Laboratory & Ambulatory Surgical Center(Out Patient Hospital). My experience engaging with large scale as well as small scale Healthcare/Billing organization has provided and helped me with different vision and approach towards critical thinking and has won several recognition and appreciations throughout my career.
Overview
4
4
years of professional experience
3
3
years of post-secondary education
3
3
Languages
Work History
SME
WECARE HEALTH SOLUTIONS
08.2022 - Current
- End to End Process management RCM experience in Laboratory, Physician, Hospital(Out patient)
- Training new agents, compiling daily production reports & assigning agents allocation of work order to the team and make sure each agent completes the task with the given TAT.
- Performing dip-stick quality audits for team on weekly basis.
- Identifying root cause analysis for repeated fatal errors to fix and improve the quality of individual agent and overall team’s quality.
- Providing feedback to agents on regular basis for errors and making them understand to address the scenario.
- Publishing Daily, Weekly & Monthly Quality Dashboard.
- Extensive AR collections experience all around for government and commercial major payers.
- Creating SOP for training and also been a supporting hand in achieving the team targets and quality assurance of the team
- Good knowledge on Denial management for doing root cause analysis to provide solution on fixing denial issues and convert them into payment.
- Ensuring to forward any new updates received from client on insurance basis or general updates via email and also discussing in team hurdles with the team
SR AR EXECUTIVE
RESOLUTE MEDICAL MANAGEMENT
02.2021 - 07.2022
- Achieved streamlined billing process by implementing efficient AR procedures
- Improved cash flow by expediting collection from past due denials
- Successfully managed Accounts Receivable (AR) for both hospital & Clinic, enhancing financial performance through effective denial management and partial ERA posting
- Working on No response claims, denial management, payer rejections, clearinghouse rejections, appeals etc.
Education
Bachelor of Commerce -
MES FIRST GRADE COLLEGE
Mysore, Karnataka 01.2014 - 01.2016
PUC - Commerce
MES PU COLLEGE
Mysore, Karnataka 01.2012 - 01.2013
SSLC - undefined
SEVENTH-DAY ADVENTIST SCHOOL
Skills
Organizational skills
Communication skills
Quick learner
Hardworking & Creativity
Innovation & Teamwork
Denial Management
Root cause analysis on denials
Rejections, Insurance Verification
Disclaimer
I certify that the information provided in this resume is true and accurate to the best of my knowledge. I hereby declare that the details furnished above are true and correct. The information presented in this resume accurately reflects my qualifications and experience.
Software
Timeline
SME
WECARE HEALTH SOLUTIONS
08.2022 - Current
SR AR EXECUTIVE
RESOLUTE MEDICAL MANAGEMENT
02.2021 - 07.2022
Bachelor of Commerce -
MES FIRST GRADE COLLEGE
01.2014 - 01.2016
PUC - Commerce
MES PU COLLEGE
01.2012 - 01.2013
SSLC - undefined
SEVENTH-DAY ADVENTIST SCHOOL