Wilfred George
Dubai
Summary
Transport Manager with extensive expertise in logistics, fleet management, and parent relations. Proven track record in coordinating transportation operations while ensuring safety compliance and optimizing routes for maximum efficiency and cost-effectiveness. Exceptional at fostering strong relationships with parents, addressing concerns promptly, and delivering a seamless transport service experience. Committed to enhancing service quality and customer satisfaction through effective staff management, strategic scheduling, and budget oversight. Eager to contribute skills to a dynamic organization and open to relocation opportunities.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Parent Relations Executive
Apple International School (Contract with Guardian One Transport)
08.2024 - Current
- Managed transportation operations, ensuring safe and efficient routes for students.
- Oversaw a fleet of 34 buses, including 24 for regular and KG trips and 10 for CLB operations, coordinating a total of 7 dispersals for students, teachers, and administrative staff.
- Scheduled routes, supervised drivers, and ensured adherence to safety and compliance regulations.
- Cultivated strong relationships with parents, addressing inquiries, resolving concerns, and ensuring satisfaction.
- Acted as a liaison between parents and the organization, facilitating clear and effective communication.
- Organized and participated in parent engagement programs to foster a collaborative community.
- Maintained detailed records of interactions and feedback to ensure timely follow-ups and process improvements.
- Collaborated with teams to develop strategies enhancing parent experiences and transportation efficiency.
- Supervised driver training to uphold safety and professionalism, addressing and resolving operational issues promptly.
- Regularly communicated transportation updates and guidelines to stakeholders.
Quality Analyst, claims Auditor
Omega healthcare RCM services Pvt Ltd
03.2022 - 08.2024
- Perform regular audits of medical billing processes and claims to ensure accuracy, compliance with healthcare regulations, and adherence to coding standards (ICD-10, CPT, HCPCS).
- Analyze billing data and reports to identify trends, errors, and areas for improvement in the billing cycle.
- Collaborate with the billing, coding, and claims teams to address discrepancies, improve processes, and minimize claim denials or rejections.
- Review claims for completeness, accuracy, and compliance with payer-specific guidelines, including Medicare, Medicaid, and private insurance.
- Develop and implement quality control procedures to enhance the accuracy and efficiency of billing operations.
- Generate reports on audit findings and present recommendations to management for process improvements and training initiatives.
- Monitor and evaluate billing staff performance to ensure high levels of accuracy and compliance with industry standards.
- Assist in the development of training materials and conduct training sessions for billing and coding staff to address recurring errors and improve quality.
- Stay updated on industry changes, including coding updates, payer policies, and regulatory requirements, to ensure ongoing compliance.
- Collaborate with the compliance team to ensure adherence to HIPAA and other relevant regulations in medical billing processes.
- Assist in implementing corrective action plans to address identified issues and enhance the overall billing process.
- Conduct root cause analysis on denied or rejected claims to prevent future errors and maximize reimbursement rates.
Claims specialist
Tharworx
11.2020 - 02.2022
- Review and process insurance claims by verifying the accuracy of information, ensuring proper documentation, and compliance with payer policies.
- Investigate and resolve claim discrepancies, coordinating with insurance providers, healthcare providers, and policyholders to gather necessary details.
- Analyze claims for coverage, coding, and payment accuracy, applying knowledge of ICD-10, CPT, and HCPCS codes.
- Submit and follow up on insurance claims, addressing denials, rejections, and appeals to maximize reimbursement.
- Communicate with insurance companies and third-party payers to confirm claim status and resolve issues related to billing, payment, or coverage.
- Interpret Explanation of Benefits (EOBs) to reconcile claim payments and patient account balances.
- Collaborate with internal teams, including medical billing, coding, and finance departments, to ensure timely and accurate claims submission.
- Assist patients and policyholders by explaining coverage details, claim processes, and payment obligations.
- Maintain detailed records of claim transactions, follow-ups, and communications for auditing and compliance purposes.
- Stay updated on changes in insurance policies, claim submission procedures, and regulatory requirements (Medicare, Medicaid, private insurance).
- Meet or exceed performance metrics related to claim processing times, accuracy, and collection rates.
- Ensure compliance with HIPAA regulations and handle confidential patient information securely.
Medical billing specialist
ACN healthcare RCM services Pvt Ltd
10.2017 - 01.2020
- Process and submit accurate claims to insurance companies, ensuring compliance with payer regulations, coding standards, and healthcare policies.
- Verify patient insurance coverage and eligibility before services are rendered, confirming accurate billing information.
- Utilize medical billing software to generate, review, and submit both electronic and paper claims for various payers (Medicare, Medicaid, private insurance).
- Correct and re-submit denied or rejected claims by researching payer requirements, coding errors, and other discrepancies.
- Ensure accurate coding using ICD-10, CPT, and HCPCS codes based on medical records, physician notes, and services rendered.
- Manage billing cycle processes including charge entry, payment posting, and account reconciliation.
- Coordinate with healthcare providers and office staff to obtain missing or incomplete information necessary for accurate claim submission.
- Perform follow-up on unpaid or underpaid claims, contacting insurance companies for resolution and timely reimbursement.
- Handle patient billing inquiries, providing information on balances, charges, and payment options.
- Generate reports on billing activities, claims status, and accounts receivable to provide management with actionable insights.
- Maintain confidentiality and ensure compliance with HIPAA regulations in handling patient information.
- Stay up-to-date with industry regulations, payer policies, and coding changes to ensure ongoing compliance and efficiency in billing operations.
Medical billing executive AR
Vee Technologies
08.2015 - 05.2017
- Manage and monitor accounts receivable balances, ensuring timely and accurate processing of medical claims and payments.
- Analyze and resolve billing discrepancies, denials, and rejections by working with insurance companies, healthcare providers, and patients.
- Perform regular follow-up on unpaid claims with insurance carriers to ensure prompt collection of outstanding balances.
- Process claims through electronic and paper submissions while ensuring compliance with insurance regulations and payer guidelines.
- Collaborate with the billing team to track, report, and escalate aging accounts to maximize revenue collection.
- Communicate with patients regarding outstanding balances, payment plans, and financial assistance options.
- Review and interpret Explanation of Benefits (EOBs) to ensure correct reimbursement and identify discrepancies.
- Post payments and adjustments accurately, reconciling patient accounts as needed.
- Maintain detailed documentation of all collection activities and communications for auditing and reporting purposes.
- Stay updated on changes in medical billing codes (CPT, ICD-10) and insurance procedures to ensure compliance.
- Meet or exceed monthly collection targets while maintaining a high level of accuracy and professionalism.
- Collaborate with management to improve billing processes and enhance accounts receivable performance.
Education
Bachelor's of Commerce - Accounts and Finance
Institute of Basic and Vocational education
06.2015
Skills
- Administrative experience
- Customer service
- Communication skills
- Microsoft Office
- Cash handling
- Organizational skills
- Leadership
Certification
- Microsoft Power BI
- Advanced Excel
- Lean six sigma green belt
Timeline
Parent Relations Executive
Apple International School (Contract with Guardian One Transport)
08.2024 - Current
Quality Analyst, claims Auditor
Omega healthcare RCM services Pvt Ltd
03.2022 - 08.2024
Claims specialist
Tharworx
11.2020 - 02.2022
Medical billing specialist
ACN healthcare RCM services Pvt Ltd
10.2017 - 01.2020
Medical billing executive AR
Vee Technologies
08.2015 - 05.2017
Bachelor's of Commerce - Accounts and Finance
Institute of Basic and Vocational education
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