Dr. Naveeda Hanif Email & Phone Number

Dubai, Ae

Dubai, United Arab Emirates

Dubai, United Arab Emirates

Responsibilities • Leading a claims team and assisting them to ensure company objective is met.• Effective management of Group Life and Medical claims for UIB clients.• Preparation and implementation of process flows for claims administration.• Preparation & Analysis of weekly/monthly claims TAT report as required by client/management.• Inventory Management and analysis.• Maximizing operational performance by providing technical advice to team members and their training in line with company compliance.• Review the disputed/declined claims and verify if the denial is in line with policy terms and conditions. • Negotiate grey area claims with the insurers.• Arrange regular meetings with clients/insurers for amicable resolution of such disputed claims or escalations.• Coordinate and arrange health awareness sessions/presentations for clients.• Preparation of SoEs for Group Life claims.• Coordination with Team members/Insurers and clients for any premium issues so that claims are not affected.• Manage excellent relationship with the insurers/TPAs & clients.• Preparation of Claims Process & Procedure for our clients and guide them through these procedures.• Preparation of claims analysis and orientations of benefits/processes etc.• Evaluation, arrangement, contact with providers for wellness sessions for UIB clients.

Dubai, United Arab Emirates

Responsibilities:• Commended for communicating efficiently with the senior management, co-workers & peers.• Contributed as subject matter expert, mentoring teams and enhancing skill development for them.• Employed experience and excellent understanding of latest medical software to deal with ambiguity and changing business environment.• Worked towards maximizing profits and minimizing losses to accomplish organizational goals and objectives.• Appreciated for performing day to day business operations and maintaining customer relations.• Exercised solutions-oriented approach in handling and resolving complaints from DHA/HAAD and Insurance Authority.• Prepare correspondences, reports, presentations, documents, processes for monthly analysis.• Set-up documents & recovery processes for identifying insurance fraudulent practices and ineligible cases.• Organize wellness and awareness programs for HNI’s and VIP clients.• Diligently review and analyze complex cancer cases.• Supervise client escalation and coordinate with Sales, Underwriting and Operations departments and Marketing and IT teams to ensure enhanced service and customer experience for walk in and virtual customers.• Closely monitor and organize all client invoices and perform timely assessment for all payment issues.• Administer process management tools and ensure compliance to all cycle guidelines.• Review internal & external audit reports along with admission documents for IPD and OPD patients.• Liaise with Quality Assurance and Product Management team to ensure accuracy on all deliverables.

Dubai, United Arab Emirates

Responsibilities:• Skilled in designing and developing medical processes and procedures to ensure customer satisfaction.• Maintained a safe and secure work environment to develop personal growth opportunities.• Credited for speeding up settlement of claims within notified timeline.• Responsible for screening and reviewing claim forms to identify principal and secondary diagnosis based on the regulatory guidelines.• Addressed critical, complicated cases and inquiries within the turnaround time.• Acquired specific CPT and ICD-10 codes to ensure proper documentation and billing of patients.• Deployed thorough knowledge of codes mapping, core system project & development of UAT to adhere to compliance, accuracy and timeline protocols.• Successfully laid down the procedure for patients’ eligibility, payment verification & medical authorization.• Presented weekly and monthly reports to the Management and Senior Authorities.• Strengthened and maintained customer relations and assisted them during walk-in, telephonic or email inquiry to establish utmost client satisfaction.

New Delhi, Delhi

Responsibilities• Continuously assessed the breadth and depth of hospital services offered across the system to ensure the organization was meeting the needs of the people it served.• Advised patients about diet, hygiene, and methods for prevention of disease.• Actively involved in building relationship with the medical fraternity for change management.• Conducted assessment, diagnosis, treatment, referral and health education for all.• Accountable for prescribing medical treatment and clinical drugs to patients.• Dexterously interfaced & coordinated with doctors, physicians, surgeons, nurses, health care technicians, other medical staff members and health care professionals involved with the primary care, treatment and rehabilitation of patients.

New Delhi, Delhi

Responsibilities• Administered treatment, medication, therapy, vaccinations and other medical care to treat patient diseases, injuries and illnesses.• Methodical in scheduling pre-admission tests and pre-operative education on treatment procedures, obtaining detailed patient history and insurance authorization, if any.• Ensured all treatments done were successful and advised patients for further review, testing and diagnosis.• Organized preventative medical programs for individual patients.

Fraud Waste And Abuse, Insurance, A

Cpma, (Medical Coding & Auditing)

Bachelor Of Medicine, Bachelor Of Surgery - Mbbs, Medicine, A