SYED MOHD ZAKI ALI
Hyderabad
Summary
Dynamic Senior Claims Specialist with a proven track record at OPTUM GLOBAL SOLUTIONS, showcasing strong communication skills and analytical problem-solving. Excelled in optimizing billing and collections processes, significantly improving cash flow. A valued team player and leader, adept in MS Office and Oracle, consistently exceeding performance metrics.
Overview
9
9
years of professional experience
Work History
Senior Claims Specialists
OPTUM GLOBAL SOLUTIONS
09.2022 - Current
- Operate AR Pharmacy Billing and Collections Claims Management.
- Operate clients' requests and escalations via email and phone.
- Audit the posted invoices, and reply to the audit queries.
- Prepare sheets and reports for different projects (Appeals, Reconsideration, and Adjustments).
- Worked on multiple projects, such as Central Payers, Commercials, and Copay.
- Support weekly updates and process map guidelines with the team.
- Operate collections and the billing process for better claims management.
- Overseeing the entire process from billing to final payment, denied, or pending, optimizing the process to improve cash flow.
Senior Process Executive
INFINIX PVT LTD
Hyderabad
09.2020 - 07.2022
- Worked as a Radiology Provider.
- Operate collections management of new claim submissions, and follow up on claims.
- I worked in the Escalated Team for high-dollar claims, appeals, and the grievance team.
- Maintain and update patient billing files to send to the appropriate team.
Senior Process Executive
COGNIZANT
03.2018 - 09.2019
- Operate DME providers, clients, and vendors.
- Connect with the clients regarding queries and updates.
- Work with various internal stakeholders, and follow up with them to ensure the collection of payments.
- Escalate high-end issues to higher management for balancing the payments in accounts receivable, and maintain transparency within the team.
- Facilitate a training session for the new joiners.
Process Executive
AGS HEALTH PRIVATE LIMITED
Hyderabad
03.2016 - 11.2017
- Initiated career in the RCM Healthcare Industry.
- Top performer with good knowledge in training.
- Worked for Ambulatory Care Services.
- Submitting claims to insurance companies, ensuring accuracy and compliance with regulations, timely filing limits, and instructions of payers.
- Follow up on unpaid claims with insurance, verify patient information, and resolve billing issues.
- Associate and responsible for claims and denial management.
- Worked for follow-up claims and the Courtesy Appeals Department.
- Top performer in a team's consistency.
- Consistently met and exceeded all the parameters.
Education
B.COM - Accounting And Finance
ST. PAUL’S DEGREE COLLEGE (OSMANIA UNIVERSITY)
Hyderabad12-2012
Intermediate - Commerce
SRI SRINIVASA JUNIOR COLLEGE
Hyderabad01.2009
SSC -
KOHE NOOR HIGH SCHOOL
01.2007
Skills
- Strong Communication and Interpersonal Skills
- Analytical Problem Solving
- Valued Team Player
- Positive Attitude
- Well organized and punctual
- Exhibit leadership qualities
- Thrives under pressure
- Good knowledge on MS office tools (word, excel and PowerPoint)
- Worked on Citrix
- Worked on Oracle
- Good knowledge on sales force oracle – related to shipping product
- Keen interest to learn and enhance knowledge each day
- MS Office (Excel, Word)
- Java Oracle
- Accounting Package (Tally)
Affiliations
- Volunteer work for program's, events and sports activities
- Key member of Cricket Team for process.
- Nominated multiple times for Buddy up program.
Languages
Hindi
First Language
English
Proficient (C2)
C2
Accomplishments
- Bagged various awards as "Rising star" and "Star of the Month".
- Awarded with "Spot Award" for quickly learning other process, helping teams to clear baclogs, deficits and mentoring co-workers.
- Gained international exposure while working and interacting the offshore clients in execution of the project.
Timeline
Senior Claims Specialists
OPTUM GLOBAL SOLUTIONS
09.2022 - Current
Senior Process Executive
INFINIX PVT LTD
09.2020 - 07.2022
Senior Process Executive
COGNIZANT
03.2018 - 09.2019
Process Executive
AGS HEALTH PRIVATE LIMITED
03.2016 - 11.2017
B.COM - Accounting And Finance
ST. PAUL’S DEGREE COLLEGE (OSMANIA UNIVERSITY)
Intermediate - Commerce
SRI SRINIVASA JUNIOR COLLEGE
SSC -
KOHE NOOR HIGH SCHOOL
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