Bency Thomas Email & Phone Number

United Arab Emirates

Jumeirah, Dubai, Uae

◉ Supervises the team of Billing and Claims unit of the Hospital. ◉ Provide training to the concerned units to ensure timely Submission/Re-submission of claims with low RR. ◉ Ensure the team evaluate & process medical claims according to the accepted billing rules and guidelines agreed with the payers within the expected daily target, quality & other key performance indicators (KPI’s) ◉ Ensure accurate application of contractual prices and discounts, schedule of benefits, correct… Show more ◉ Supervises the team of Billing and Claims unit of the Hospital. ◉ Provide training to the concerned units to ensure timely Submission/Re-submission of claims with low RR. ◉ Ensure the team evaluate & process medical claims according to the accepted billing rules and guidelines agreed with the payers within the expected daily target, quality & other key performance indicators (KPI’s) ◉ Ensure accurate application of contractual prices and discounts, schedule of benefits, correct allocation of benefits, collection of deductibles, co-payments, observance of policy limits, and adherence to claim submission protocols.◉ Contribute in developing, updating & implementing the guidelines for evaluation and processing of medical claims, as well as policies and procedures and work-instructions related to medical claims review and processing. ◉ Deliver high quality customer service and respects medical and work ethics at all times. ◉ Responsible for informing & guiding concerned departments of any billing discrepancies reflected during daily screening of invoices. ◉ Process the Claims Submission & Re-submission for Insurance Companies within the agreed deadlines. ◉ Coordinating with Insurance companies/corporate clients for submission and re-submission related queries. ◉ Assist accounts receivable person in follow-up of pending/outstanding payments/unpaid invoices with Insurance Companies as and when required. ◉ Work Closely with Management as well as other subsidiary departments in rectification of the causes of rejection and take necessary steps/precautions to decrease the rejection rate. ◉ To assist in designing protocols for insurance practices in the Hospital, and ensure to create system rules to ensure high level of quality and reduce the user dependency for processing claims. ◉ Played a significant role in development and functionality of new HIS system for Front Desk, Billing and RCM operations and liaising with technical support as and when required. Show less

Dubai, United Arab Emirates

◉ Oversees the operations & training of the Insurance & Billing department, encompassing medical coding, charge entry, claims edits & submissions, payment posting, accounts receivable follow-up and Denial management.◉ Serves as the SME and SPOC for all Insurance and Billing processes.◉ Responsible for maintaining and updating of Insurance Companies and its networks contracted with DHA facilities.◉ Ensures that the activities of the billing operations are conducted in a manner that… Show more ◉ Oversees the operations & training of the Insurance & Billing department, encompassing medical coding, charge entry, claims edits & submissions, payment posting, accounts receivable follow-up and Denial management.◉ Serves as the SME and SPOC for all Insurance and Billing processes.◉ Responsible for maintaining and updating of Insurance Companies and its networks contracted with DHA facilities.◉ Ensures that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol, and are in compliance with regulator, payer regulations, guidelines, and requirements.◉ Participates in the development and implementation of operating policies and procedures.◉ Played an important role in knowledge acquisition process to understand the AS-IS operational aspects taking place and thereby creating a TO-BE workflow process by incorporating the Insurance part. ◉ Supervises billing office personnel, which includes work allocation, training, and being available for staff needs; motivates employees to achieve peak productivity and performance.◉ Played a major role in providing introduction and training to all the staffs on the different usage of eClaimlink such as claim submission, uploading of XML files, downloading of RA files, member eligibility checking, e-Authorization, Search member using EID, Clinician ID updation, downloading of updated list of DDC codes, Clinicians, Payers from data dictionary.◉ Played a significant role in developing & implementing a new software solution (myCARE) which handles the entire life cycle of RCM process. (Patient registration till final payment) ◉ Managed the team of Denial Management, AR Follow-up, Claim Submission, Billing Training & Onsite Insurance operations. Show less

Dubai

◉ Responsible for supervision & monitoring of received claims from contracted providers.◉ Responsible for Submission of E-Claims through HAAD/DHA portals & Paper claims to payers.◉ Responsible for monitoring claims movement and workflow within the Claims Receiving unit.◉ Responsible for allocation of claims needed for processing to various internal departments.◉ Prepare and review Insurance-claim forms and related documents for accuracy and authenticity before onward submission… Show more ◉ Responsible for supervision & monitoring of received claims from contracted providers.◉ Responsible for Submission of E-Claims through HAAD/DHA portals & Paper claims to payers.◉ Responsible for monitoring claims movement and workflow within the Claims Receiving unit.◉ Responsible for allocation of claims needed for processing to various internal departments.◉ Prepare and review Insurance-claim forms and related documents for accuracy and authenticity before onward submission to HAAD/DHA.◉ Providing various rules to the Quality Assurance Department to be implemented in Billing system to prevent validation errors for a smooth and successful submission.◉ Co-ordinating & liaising with Insurance department of our clients for Medical Records. ◉ Co-ordinating with various Insurance Companies across UAE for e-claims related queries.◉ Imparting training to team members regarding recent updates of Insurance circulars for Implementation and conducting meetings on a weekly basis.◉ Imparting Induction training for new joinees.◉ Scrutiny of Pre-submission report for the accuracy of data such as payer ID and verification of price related discrepancies. ◉ Attending internal price related issues for billing & bringing it to the notice of Insurance/ IT Dept.◉ Query Management with each clients with respect to their E-claims.◉ Co-ordinating and providing assistance to Medical Auditors/Coders during submission.◉ Sending Post Submission reports & various MIS reports to Upper management and Clients.◉ Dealing with various insurance companies for any clarifications/concerns after claim submissions.◉ Providing assistance to Finance Department with regards to Reconciliation Process.◉ Uploading of Re-Submission XML file(s) to regulator portals.◉ Managing office and administrative duties & providing due support to other internal departments and reporting to Operations Manager.◉ Screening for new system software; Implementation & planning to meet the needs of the company. Show less

Cochin Area, India

◉ Handling of documentation & MIS related to Advisor recruitment activities for the region.◉ Policy Owner Servicing & Managing Branch Persistency.◉ Basic underwriting of Insurance policies & ensuring 90% above Issuance for every month.◉ To exercise control over all critical activities being conducted at reporting branches.◉ Ensure implementation of all new process at reporting branches.◉ Ensure action aimed at cost control at reporting branches.◉ Adeptly involved in… Show more ◉ Handling of documentation & MIS related to Advisor recruitment activities for the region.◉ Policy Owner Servicing & Managing Branch Persistency.◉ Basic underwriting of Insurance policies & ensuring 90% above Issuance for every month.◉ To exercise control over all critical activities being conducted at reporting branches.◉ Ensure implementation of all new process at reporting branches.◉ Ensure action aimed at cost control at reporting branches.◉ Adeptly involved in Internal Audit of various departments & sending reports to zonal office.◉ Compliance Management & Ensuring Quality Customer Service in all parameters.◉ Cash and Cheques operations, Cheque Bounce management and Petty cash management.◉ Verification, Lodgment and Reconciliation of Premium cash collections & instruments.◉ Maintenance of all the registers & trackers associated with daily operational activities.◉ Providing timely MIS Reports to upper level management.◉ Maintaining all transaction records as per Audit parameters.◉ Handling Administrative & labour related works.KEY FOCUS AREAS◉ Quality of proposal forms & error free processing.◉ Compliance with financial and process controls.◉ Reconciliation of records.◉ Preparation of Internal Audit reports & ensuring the branch gets best Audit rating.◉ Accuracy of cashier entries passed at branch, verification & reconciliation.◉ Ensuring maintenance of 100% SLA.◉ Productivity & overall performance of branch & TAT’s of branch level activities.◉ Monitoring Cost incurred to run operations at branch level.◉ Ensuring completeness of Branch as per Labour, Shop & Establishment Rules.◉ Facilitate the working environment for Staffs and Branch Hospitality. Show less

Cochin Area, India

◉ Responsible for the entire clearing/transaction & other back office work for 26 branches in the region with certain volume on an average per day.◉ Responsible to follow the rules & regulations in clearance of cheques & other instruments.◉ Electronic clearing settlements, monitoring clearing funds position, reconciliation of clearing accounts, ensuring error-free processing.◉ Monitoring the timely submission of reconciliation statement of clearing account maintained with State Bank… Show more ◉ Responsible for the entire clearing/transaction & other back office work for 26 branches in the region with certain volume on an average per day.◉ Responsible to follow the rules & regulations in clearance of cheques & other instruments.◉ Electronic clearing settlements, monitoring clearing funds position, reconciliation of clearing accounts, ensuring error-free processing.◉ Monitoring the timely submission of reconciliation statement of clearing account maintained with State Bank of Travancore to Head Office on a fortnightly basis.◉ Maintains and accounts for cash drawer and daily transactions; reports discrepancies. ◉ Reviewed and analyzed the data on a monthly basis in order to send reports to management.◉ Cash Processing, Verification, Reconciliation & passing Accounting Entries◉ Operation of G & D Currency Note Processing Machine & detection of Forged, Mutilated, Defaced, Mismatched & Soiled notes. Show less

Cochin Area, India

◉ Responsible for the day-to-day management of the accounting and internal reporting on specific accounts activities. ◉ Preparation of entire branch accounts up to finalization & Bank Reconciliation Statements.◉ Supervisory control over the all Foreign Exchange related activities & accounting entries.◉ Assisting payment related activities towards the customers of Western Union Money Transfer.◉ Manage Petty Cash; Maintain & manage Accounts Receivables & Accounts Payable… Show more ◉ Responsible for the day-to-day management of the accounting and internal reporting on specific accounts activities. ◉ Preparation of entire branch accounts up to finalization & Bank Reconciliation Statements.◉ Supervisory control over the all Foreign Exchange related activities & accounting entries.◉ Assisting payment related activities towards the customers of Western Union Money Transfer.◉ Manage Petty Cash; Maintain & manage Accounts Receivables & Accounts Payable records.◉ Coordinate with accounts receivable team in collecting payments from customers.◉ Responsible for Receipts, Payments, Lodgment, Reconciliation of Cash/Instrument transactions.◉ Voucher preparation for all the transactions & passing entries into the accounting system.◉ Conduct Internal Audits and prepare periodic Financial Statements for Managers’ information, including Profit and Loss Accounts, Balance Sheet, Schedules, Cash flow statement etc...◉ Preparation of monthly General Ledger accounts, T.D.S Calculation & MIS reports.◉ Ensure compliance with local tax and legal requirements.◉ Evaluate existing financial information systems and suggest improvements.◉ Preparation of Wages Register, Administration duties and labour related works.◉ Co-ordinates activities with other departments and work groups as needed. Show less