ANCILLA MENDONCA
Dubai,UAE
Summary
10 years of rich experience in Clinic Administration. Areas of expertise include Medical Billing, Revenue Cycle management. In-depth knowledge of patient observation protocols. Liaise with medical staff and oversaw day-to-day activities of the organization. Motivated, self-started and highly collaborative, able to produce high quality results in high pressure situations in a dynamic environment.
Overview
10
10
years of professional experience
5
5
years of post-secondary education
1
1
Certification
Work history
Patient administrator
Mediclinic Middle East
Dubai, UAE
08.2024 - Current
- (Pre-authorization officer) In-charge of obtaining OP approval request along medical reports with CPT and ICD 9 or 10 codes to insurance companies through email, online entry/fax and as well as taking verbal approval for urgent or emergency cases.
- Coordinating between insurance companies regarding eligibility, payments, approvals, and other requirements.
- Audit claims in terms of the medical correlation, attachments, information and approvals before submitting or resubmitting them. Submission claims and resubmission rejected claims through DHPO E-Claim Link.
- Training and coordinating with the billing officer and receptionists regarding the correct patient share and other related insurance issues.
- A good knowledge of Insurance Companies about their policies and their different discount structure. Obtain and process prior authorizations through established protocols, policies and procedures.
Insurance Coordinator
Prime Healthcare
Dubai, UAE
01.2021 - 07.2024
- Audit claims in terms of the medical correlation, attachments, information and approvals before submitting or resubmitting themSubmittion claims and resubmittion rejected claims through DHPO E-Claim Link
- Coordinated insurance claims for speedy resolution.
- Training and coordinating with the billing officer and receptionists regarding the correct patient share and other related insurance issues
- A good knowledge of Insurance Companies about their policies and their different discount structure
- Obtain and process prior authorizations through established protocols, policies and procedures
- Gather and compile data for weekly and monthly reports pertaining to claims approvals, denials, and pending claims
- Collaborated with physicians for accurate patient billing and coding procedures.
- Fulfilled regulatory requirements by preparing detailed reports on insurance claims activities regularly.
- Liaised between healthcare providers and insurers, ensuring seamless operations.
- Managed high-volume workloads under tight deadlines, demonstrating excellent organizational skills.
Medical Billing executive
Aster DM Healthcare
Dubai
09.2015 - 09.2021
- Expertise in billing of General practice, Dental, Specialties department
- Verified ICD-10 codes and CPT billing codes to ensure payment will be processed for claim under customers insurance plan
- Communicate directly with patients regarding deductibles, coinsurance, selfpay and special payment arrangement all third-party administrators – Next care, NAS, Aetna
- Coordinator with insurance or TPA for eligibility, approval and follow up status
- Well versed with all insurance portals including the different categories with the limit amount for each insurance
- Update and re-billed all unpaid claim to insurance plan via computer system or mail
- Provided administrative services to the office manager
Education
MBA - Hospital Administration
Jaipur University
UAE 01.2017 - 01.2019
Bachelor of Commerce - undefined
University of Mumbai
01.2011 - 01.2014
Skills
- M S Office
- Notepad
- XML
- CONCEPT
- HIS
Certification
- CPC Certified - AAPC
- Certified Coding With AI - AAPC
- CPMA Pursuing - AAPC
Personal Information
- Date of birth: 05/30/94
- Gender: Female
- Nationality: Indian
- Marital status: Married
Timeline
Patient administrator
Mediclinic Middle East
08.2024 - Current
Insurance Coordinator
Prime Healthcare
01.2021 - 07.2024
MBA - Hospital Administration
Jaipur University
01.2017 - 01.2019
Medical Billing executive
Aster DM Healthcare
09.2015 - 09.2021
Bachelor of Commerce - undefined
University of Mumbai
01.2011 - 01.2014
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