Kamran Abbas Email and Phone Number

RCM

- To review the Claims/Billings process, find out the deficiencies or weakness in Billing, recommend changes to rectify it.- To review the Contract/ Policies/ Purchase deal in order to suggest recommendation for the betterment of the group.- Undertake the identification and evaluation of different department’s audit risk areas through a risk-based audit methodology, and manage the preparation of the Technical Audit reports on timely basis based on the identified risks and in consultation with the Management, Regulatory and Compliance requirements.- Ensure that audit procedures are strictly adhered to, including identifying and defining issues, developing criteria, reviewing and analyzing evidence, and documentation of processes and procedures; - Manage resource planning and requirements for the different audit assignments and special assignments; - Manage the audit assignments progress and escalate any show stoppers to the Group Chief Audit Executive for the intervention; - Review the audit programs to ensure the appropriate testing mechanisms, execute the audit program, recognize control weaknesses, assess the materiality of these weaknesses, and relate them back to the scope and objectives of the audit; - Communicate the results, findings and recommendations of audit projects via written reports and face-to-face presentations on a timely basis to the management.- Identifying if and where processes are not working as they should, and advising on changes to be made.- Ensuring procedures, policies, legislation and regulation are correctly followed and complied with and recommend the changes on time to time for the betterment of the group.

- Heading the team providing health care facilities to the US Embassy staff Pan Pakistan.- To supervise the entire claims and auditing process in order to settle the claims in accordance with policy and within stipulated time frame- Re-building of claim section and operation of health division. - Supervise the process of Pre-Authorization.- Re -building of medical department of health division. - Restructuring of claim processing procedure. - Incorporation of system base changes thru I.T- To deal with clients and hospitals. - Address client queries. - To give medical and claim related suggestion/point of view to policy administration department. - To work with policy administration department to review the policy document. - To suggest further system based changes to I.T department for continuous up gradation of system. - To increase number of network hospitals. - Client and hospital visits when needed. - To provide claim related reports to the client where needed. - To train the staff according to the new market trend.- Provide complete orientation/presentation to the clients apropos health policies.- Design the strategy in order to minimize the claims loss ratio.- Timely communicate the new client expectation to the staff for smooth and hassle free operation.

- To manage smooth claim processing within stipulated time frame- Respond to client queries- Client visits- Presentation on Claim Management- To generate & provide claim reports

• As a Health Promotion Officer my responsibilities includes running a Diabetic Clinic, CHD Clinic, Hypertension Clinic, Asthma Clinic under supervision of Dr. Sultan (MRCGP) and doing medication review.