yasir ahamed

• Executed end-to-end Physician Billing processes (CMS 1500), efficiently contacting U.S. insurance companies to resolve outstanding claims and maximize revenue for healthcare providers.
• Navigated complex denial scenarios, including Authorizations, Timely Filing, and invalid CPT codes, while managing diverse payers such as Medicare Advantage, Medicare HMO, Medicaid, and commercial payers.
• Leveraged NEXTGEN software to track and analyze claim statuses, ensuring compliance with evolving industry trends and insurance regulations.
• Cultivated strong collaborative relationships with colleagues to drive superior team performance and operational efficiency.

• Worked as an AR End to End Process Executive in Hospital Billing(UB04)
• Need to contact the insurance companies (in US) on behalf of healthcare providers for the outstanding medical claims.
• Identifying and resolving the issues of the unpaid claims. Worked in Pilot project Corewell Health.
• Correcting the errors and appealing the denials for Timely payment.
• A denial that was worked frequently like Authorizations. Timely Filing, Medical Records, Appeals, Invalid Cpt codes, Inclusive, adjustments, Etc..,
• Undergone with different scenarios and different Payers.
• Payers that were handled Medicare Advantage, Medicare HMO, Medicaid, and commercial payers.

Software that is used is Epic.

• Updating ourselves by knowing industry trends and changes in insurance regulations upon the denials.
• Main focus is to get the revenue for the clients.
• Built and maintained strong working relationships with colleagues to improve overall team performance and efficient working.

Achievements:

❑ Top performer in productions.

❑ Target Achiever.

❑ Top performer in Quality.

❑ Acting SME.

• Prepared and implemented lesson plans covering required course topics.
• Prepared comprehensive English curriculum for multiple classes.
• Utilized multimedia strategies and technology to convey information in fresh and interesting ways.
• Planned dynamic lessons to increase student comprehension of books and literary concepts.
• Participated in professional development opportunities to stay up-to-date on teaching best practices and enhance educator skills.
• Handled class of 9th and 10th grade.
• Worked with other teachers to support struggling students and provide thorough help to rectify comprehension issues.
• Encouraged students to take active role in learning and academic success.
• Provided guidance and mentoring to students regarding academic, social and emotional issues.
• Monitored student progress and provided feedback to both students and parents.

• Restocked and organized merchandise in front lanes.
• Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
• Worked flexible schedule and extra shifts to meet business needs.
• Greeted customers entering store and responded promptly to customer needs.
• Helped customers complete purchases, locate items, and join reward programs.
• Addressed customer needs and made product recommendations to increase sales.
• Stocked, tagged and displayed merchandise as required.
• Counted money in cash drawers at beginning and end of shifts to maintain accuracy.
• Assisted customers with returns, refunds and resolving transaction issues.
• Encouraged customers to make additional purchases by highlighting current deals and keeping lane well-stocked.
• Used POS system to enter orders, process payments and issue receipts.