Abdul Sami Rasheed Mohammed Email and Phone Number

• Working as a Medical Underwriter Officer for Insurance Department.• Working on Individual new and renewal businesses for Basic and FCP Plans.• Analysis and rate medical insurance new/renewal schemes as per the set underwriting guidelines, Issue quotes with relevant terms & conditions.• Coordinating with TPA/RI for new product code for new policies as per the regulatory requirement (DHA).• Coordinating with IT department for the integration/policy issuance/CN/DN/CHI.•… Show more • Working as a Medical Underwriter Officer for Insurance Department.• Working on Individual new and renewal businesses for Basic and FCP Plans.• Analysis and rate medical insurance new/renewal schemes as per the set underwriting guidelines, Issue quotes with relevant terms & conditions.• Coordinating with TPA/RI for new product code for new policies as per the regulatory requirement (DHA).• Coordinating with IT department for the integration/policy issuance/CN/DN/CHI.• Coordinating with TPA/claims team for the claim ratio issues.• Adhering to compliance as per DHA guidelines and assistance compliance teams when we receive internal and external (CBUAE) compliance.• Training new joiners and brokers on portals and products. Show less

• Worked as an Insurance Operations Assistant/Underwriter for Medical & General Department.• Worked on Individual/Group/SME new and renewal businesses for Medical & General policies.• Issuing insurance policies online from portals and offline for various providers.• Worked endorsement (Addition/deletion of the members) for client’s entire policy period.• Prepared quotations for the clients/sales representative.• Coordinating with Insurance Underwriters for quotations over… Show more • Worked as an Insurance Operations Assistant/Underwriter for Medical & General Department.• Worked on Individual/Group/SME new and renewal businesses for Medical & General policies.• Issuing insurance policies online from portals and offline for various providers.• Worked endorsement (Addition/deletion of the members) for client’s entire policy period.• Prepared quotations for the clients/sales representative.• Coordinating with Insurance Underwriters for quotations over emails & calls and follow-ups with Insurance companies.• Assisting client’s for their renewal of the policy and after sales services.• Maintaining MIS and compliance Logs sheet on daily basis.• Adhering to compliance as per DHA guidelines and submitting yearly report to DHA.• Maintaining SOP, PHIR’s file as per DHA guidelines.• Training new PHIR’s and doing on boarding process for new PHIRs. Show less

• Working as an Insurance Manager for Medical Centre.• Preparing Daily Summary Report (DSR) on daily basis.• Coordinating with Insurance Companies for Impaneling, Tariffs and payments.• Checking member eligibility with insurance through web portal.• Taking approvals for GP & SP, Lab & Dental services through online web portal (E-claim link & DHPO) and mails.• Handling Claims Submission, Re-submission & Reconciliation as per DHA guidelines and generating XML File.•… Show more • Working as an Insurance Manager for Medical Centre.• Preparing Daily Summary Report (DSR) on daily basis.• Coordinating with Insurance Companies for Impaneling, Tariffs and payments.• Checking member eligibility with insurance through web portal.• Taking approvals for GP & SP, Lab & Dental services through online web portal (E-claim link & DHPO) and mails.• Handling Claims Submission, Re-submission & Reconciliation as per DHA guidelines and generating XML File.• Handling Admin work like renewal of License for Doctor’s & Nurses and Clinic License. Show less

• Worked as an Insurance Coordinator for Clinic and Labs BU (Business Unit).• Registering patient’s details in software, coding (ICD-10) and billing accordingly.• Checking member eligibility with insurance through web portal.• Handling and solving patients query via calls (Inbound and Outbound) and mails.• Taking approvals for GP (General Practitioner), Dentist and Labs services through online web portal (E-claim link & DHPO) and mails.• Submitting and Re-submitting the… Show more • Worked as an Insurance Coordinator for Clinic and Labs BU (Business Unit).• Registering patient’s details in software, coding (ICD-10) and billing accordingly.• Checking member eligibility with insurance through web portal.• Handling and solving patients query via calls (Inbound and Outbound) and mails.• Taking approvals for GP (General Practitioner), Dentist and Labs services through online web portal (E-claim link & DHPO) and mails.• Submitting and Re-submitting the claims manually through E-claims• Working on denials and rejection.• Communicating with Insurance companies for rejection issue.• Preparing drugs through Open-Jet and Creating ERX through E-Claims.• Answering Client’s query regarding patient’s medical policy and copay.• Preparing sick leave via DHA Portal. Show less

• Worked as a Senior Claims Specialist for Physician BU (Business Unit).• Follow up on the outstanding balance until we receive payment from insurance companies & also work on the Denials and front end rejected claims.• Preparing Appeals for Government & Commercial payers. • Follow up with all commercial insurances along with Government & Commercial payers.• Maintained & Prepared MIS reports on team attendance and production of day-to-day report and forwarding to Team Lead &… Show more • Worked as a Senior Claims Specialist for Physician BU (Business Unit).• Follow up on the outstanding balance until we receive payment from insurance companies & also work on the Denials and front end rejected claims.• Preparing Appeals for Government & Commercial payers. • Follow up with all commercial insurances along with Government & Commercial payers.• Maintained & Prepared MIS reports on team attendance and production of day-to-day report and forwarding to Team Lead & Manager.• Auditing the accounts of the team.• Trained the new hires on the process and provided feedback to them.• Conducting Team Huddle on daily basis. Show less

• Worked as a Senior Process Analyst for Hospital, Physician & Ambulance BU (Business Unit).• Follow up on the outstanding balance until we receive payment from insurance companies & also work on the Denials and front end rejected claims.• Daily work on Account Receivables and Account Payable (AR/AP) for Hospitals and Clinics across United States of America.• Provide training on process updates & software, Billing and Follow-up (AR/AP) to all new joined employees in process and… Show more • Worked as a Senior Process Analyst for Hospital, Physician & Ambulance BU (Business Unit).• Follow up on the outstanding balance until we receive payment from insurance companies & also work on the Denials and front end rejected claims.• Daily work on Account Receivables and Account Payable (AR/AP) for Hospitals and Clinics across United States of America.• Provide training on process updates & software, Billing and Follow-up (AR/AP) to all new joined employees in process and mentoring them till they go live.• Prepare MIS reports on team attendance and production of day-to-day report and forwarding to team lead and manager. Show less

• Worked as a Revenue Cycle Specialist for Hospital BU (Business Unit).• Follow up on the outstanding balance until we receive payment from insurance companies & also work on the Denials and front end rejected claims.• Maintained exceptional production & quality as per the process requirement.• Follow up with all commercial insurances along with Medicare, Medicaid, No fault & Worker’s compensation.• Worked on several reports as per the process requirements.• Responsibilities… Show more • Worked as a Revenue Cycle Specialist for Hospital BU (Business Unit).• Follow up on the outstanding balance until we receive payment from insurance companies & also work on the Denials and front end rejected claims.• Maintained exceptional production & quality as per the process requirement.• Follow up with all commercial insurances along with Medicare, Medicaid, No fault & Worker’s compensation.• Worked on several reports as per the process requirements.• Responsibilities of training the new joiner’s and mentoring them till they go live.• Maintaining the track report of day-to-day work for quality check and to keep away the work related issues. Show less

• Worked as a Revenue Cycle Specialist for Physician BU (Business Unit).• Major responsibility to monitor the collections/transaction posting.• Speed up collections of claim payments through effective AR follow up.• Co-ordinate with the clients directly on resolving the issues.• Trained fresher’s to get confidence on their work.• Maintaining the track report of day-to-day work for quality check and to keep away the work related issues.