KARTHIK MONY
About Candidate
Medical Insurance coordinator. With 9 years of experience in healthcare institutions in the UAE, I am confident in my ability to provide exceptional service to your patients. Highly skilled and experienced Medical insurance, TPA,RCM Claims Submission & Revision Billing process. Medical Coding with a proven track record of ensuring seamless patient care, efficient claims processing, and excellent communication with healthcare providers, patients, and insurance companies.
Key Experience:
– Coordinated insurance claims, resulting in a 99% payment rate.
–Â Developed and implemented processes to reduce claim processing time, On time Re-Submission & Revision Billing process.
– Built strong relationships with healthcare providers, patients, and insurance companies.
– Managed patient data and insurance information with precision and confidentiality.
– Ensured compliance with DHA regulations and guidelines.
– Collaborated with healthcare teams to deliver high-quality patient care.
– Strong knowledge of UAE healthcare regulations and insurance policies.
– Excellent communication, interpersonal, and problem-solving skills.
– Proficient in MS Office, insurance software, and EMR systems.
Location
Education
Work & Experience
Submission (Outpatient and Inpatient) Receives email request for Outpatient and Inpatient Process accordingly depending on the documents needed/provided Submits request to Insurance Companies Handles queries/ rejections to be relayed to the treating physicians Escalate concerns to management related to authorization, rejection, and resubmission. Communication with Insurance Companies Insurance related issues (approval enquiries, MSC Guarantee of Payment) Communicate and follow up raised insurance concerns. Monitor, follow up and assign schedule and tasks to coders and coordinator. Attends to queries about laboratory coverage. Provides valuable information regarding laboratory and ICD coverage. Provides training to Reception about copayment, medical tourism, and other concerns.
Hospital based Medical Insurance RCM, Claims & Medical Billing processes. Hospital based IP & OP approvals submission to the Insurance companies. Coordinating with major insurance companies among UAE for approvals for OP & IP patients Responsible for submitting bills to insurance companies. Ensures follow- up regarding insurance payments. Following up with Hospital Insurance Team for necessary updates on the insurance status of the admitted patient and arrange for the necessary documents to be submitted as per requirement by insurance. Issues invoice by entering service data; calculating charges; mailing invoices. Responsible for Billing Insurance and non-insurance Invoices. Responsible for obtaining approvals/pre-authorization from Insurance companies. Resolves billing issues by discussing contract with third-party payer; explaining insurance contract with patient; negotiating settlement. Hospital based knowledge of SAP, RCM, HIS & YASASII.
Hospital based IP & OP approvals submission to the Insurance companies. Coordinating with major insurance companies among UAE for approvals for OP & IP patients Responsible for submitting bills to insurance companies. Ensures follow-up regarding insurance payments. Coordinating with nurses to make sure the discharge timings are maintained and to follow for insurance extension for overstayed patients. Keeping Track of Timely extensions with no of days. Verification of accurate CPT code with the coder. Receives email request for Outpatient and Inpatient Process accordingly depending on the documents needed/provided Submits request to Insurance Companies Handles queries/ rejections to be relayed to the treating physicians Maintains confidentiality of the patients’ file
