SyedFazil Nazer Ali
Chennai
Summary
Precision-driven Medical Auditor known for productivity and efficiency in task completion. Possess specialized skills in regulatory compliance, medical coding accuracy, and healthcare reimbursement methodologies. Excel in analytical problem-solving, communication, and time management to ensure thorough audit processes and compliance with healthcare regulations.
Overview
5
5
years of professional experience
Work History
Medical Claim Officer
MD india Health Insurance Pvt Ltd
Chennai
03.2021 - Current
- Extensive knowledge of health insurance operations
- Experienced in examining multiple patient files comprehensively
- Audited medical records spanning multiple specialties, including Cardiology and Orthopedics
- Skilled in handling claims processing for both daycare and surgery cases
- Evaluated claims based on accurate hospital diagnosis
- Collaborated with team for precise decision-making
- Scrutinized health records revealing inconsistencies signaling fraud
- Conducted thorough review of clinical documents
- Supported reporting tasks within policy guidelines
- Participated in diverse Health Scheme projects across government sectors
- Developed and implemented policies and procedures to ensure compliance with government regulations.
- Consistently maintains quality and productivity standards: Meets daily review, query, and query response targets.
- Maintain current knowledge of healthcare regulations and guidelines.
- Maintain adherence to insurance provider standards
Duty Medical Officer
Syed hospital
Tirunelveli
01.2020 - 01.2021
- Assisting the senior doctor in checking the patients
- Diagnosing the disease as per the symptoms
- Learning the diagnostic methods and equipment’s uses
- Provided medical advice and support to patients, families, and healthcare personnel.
- Developed treatment plans for patients based on diagnosis and individual needs.
- Conducted physical examinations of patients and documented findings in patient records.
- Prescribed medications as needed for the treatment of various illnesses or diseases.
- Monitored patient progress and adjusted treatments accordingly.
Education
Bachelor of Medicine and Bachelor of Surgery - MEDICINE
YEREVAN STATE MEDICAL UNIVERSITY
YEREVAN, ARMENIA07-2019
HSC -
ROSE MARY MATRIC.HR.SEC.SCHOOL
Tirunelveli, Tamil Nadu10TH CLASS -
ROSE MARY MATRIC.HR.SEC.SCHOOL
Tirunelveli, Tamil NaduSkills
- Medical Terminology
- Medical Equipment Handling
- Health Insurance Knowledge
- Auditing Medical Records
- Claims Processing
- Claims Approval and Denial
- Fraud Pattern Investigation
- Clinical Document Investigation
- Medical Documentation Verification
- Government Health Scheme Project Experience
- Medical Billing
- Audit management
- Healthcare knowledge
- Training and mentoring
Languages
Tamil
First Language
English
Proficient (C2)
C2
German
Intermediate (B1)
B1
Spanish
Beginner
A1
Timeline
Medical Claim Officer
MD india Health Insurance Pvt Ltd
03.2021 - Current
Duty Medical Officer
Syed hospital
01.2020 - 01.2021
Bachelor of Medicine and Bachelor of Surgery - MEDICINE
YEREVAN STATE MEDICAL UNIVERSITY
HSC -
ROSE MARY MATRIC.HR.SEC.SCHOOL
10TH CLASS -
ROSE MARY MATRIC.HR.SEC.SCHOOL
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