Summary
Overview
Work History
Education
Skills
Accomplishments
Languages
Timeline
Generic

Amina Abdul Shareef

Sharjah

Summary

I am a results-driven and organized Medical Coder with a comprehensive understanding of medical coding practices and insurance protocols. I am committed to maintaining the highest standards of accuracy and compliance, contributing to the overall efficiency and success of the healthcare organization I serve.
Problem solving, hardworking with good presentation and communication skill. A keen leader with ability to lead team in a demanding and challenging environment.

Overview

13
13
years of professional experience

Work History

Sr. Executive Insurance- IP

Medcare Hospital
12.2021 - Current
  • Reviewing, processing and submission of Inpatient & Daycare claims in accordance to contractual agreements and insurance specific guidelines.
  • Assisting and guiding in assigning and sequencing codes accurately based on medical record documentation.
  • Application of DHA & MOH Guidelines for claim processing and submission.
  • Querying physicians regarding incomplete documentation for further clarification on diagnoses, procedures, or medical justification.
  • Assisting approval team in acquiring approvals by providing expertise guidance.
  • Auditing coded charts for correct DRG, ICD and CPT.
  • Collaborating with Medical Records Team to ensure completeness of documentation in EMR.
  • Running Daily reports for tracking of the claims
  • Maintaining and providing Monthly and Quarterly reports
  • Conducting team meetings.
  • Conducting training session for Front Office / Billing/ Approval Staffs in relation to Coding, Billing and Insurance Protocols.
  • Conducting training session for new joinees .
  • Developing and updating of policy and protocols and ensuring adherence.
  • Coordinating with rest of the departments of the Hospital.
  • Coordinating with insurance team for approvals with proper CPTs and DSLs.
  • Verifying Approvals, Co-Pay , Deduction ,Co-Ins , Network and Eligibility.
  • Verifying contractual agreements and insurance specific guidelines before claim processing.
  • Submission of Claims as per their policies to respective post office
  • Processing of Paper claims as and when required.
  • Assistance to Resubmission and reconciliation of Inpatient claims.
  • Assisting doctors and nurses in assigning appropriate CPT's and ICD's


IP Team Leader

NMC Royal Hospital
10.2018 - 11.2021
  • Monitored team performance and provided constructive feedback to increase productivity and maintain quality standards.
  • Supervised team members to confirm compliance with guidelines.
  • Lead the IP Team in application of correct Insurance protocols and guidelines in claim processing and submission adhering to DHA and MOH protocols.
  • Processing and submission of IP Claims
  • Resubmission of OP and IP Claims.
  • Processing and submission of OP Claims
  • Assisting in Reconciliation.

Clinical Instructor

Padmashree Dr.D.Y.Patil University,
08.2010 - 09.2011
  • Clinical supervision of B.sc Nursing students in various areas like Medical and Surgical wards.

Education

Certification - CPC

AAPC
United States Of America
09.2017

Bachelor of Science - Nursing

SNDT University
Mumbai, India
06.2007

Skills

  • CPT
  • ICD 10-CM
  • HCPCS Level II
  • Anatomy and Physiology
  • Medical and Surgical procedures
  • Hospital equipments and instruments
  • Coding Guidelines Inpatient and Outpatient
  • Denial Codes
  • Soft wares- Insta, Trackcare, 3M, EncoderPro
  • Ms-Office

Accomplishments

  • Successfully revitalized operations and streamlined processes within a struggling organization grappling with backlogs, bringing everything back on track.
  • Achieved a remarkable reduction in claim rejections, effectively bringing them from an alarming high to an acceptable range through strategic interventions and process improvements.
  • Recognized as the top-performing employee during the quarterly performance assessment, earning the prestigious "Best Employee" award in recognition of exceptional dedication and outstanding contributions to the organization's success in both my current and previous employers.


Languages

English
Advanced (C1)
Hindi
Advanced (C1)
Malayalam
Bilingual or Proficient (C2)
Marathi
Advanced (C1)

Timeline

Sr. Executive Insurance- IP

Medcare Hospital
12.2021 - Current

IP Team Leader

NMC Royal Hospital
10.2018 - 11.2021

Clinical Instructor

Padmashree Dr.D.Y.Patil University,
08.2010 - 09.2011

Certification - CPC

AAPC

Bachelor of Science - Nursing

SNDT University
Amina Abdul Shareef