3M
Dr. Yumna Fazleen
Case Manager, Medical Auditor, Medical Coder
Dubai,
Summary
I am a dedicated medical professional skilled in medical claims auditing, medical coding, case management, doctors training and known for working under pressure and adapting to new situations and challenges with strong organizational skills and ready to help team achieve company goals. I also have 5 years of clinical experience. I have also contributed as a faculty in Acute Care Workshop. I am also a certified BCLS instructor with effective teaching and communication skills.
Thereby, seeking a position as a medical auditor, medical coder or case manager in healthcare and insurance industry where my medical knowledge, hardwork and skills in coding will contribute to profitability and reputation of the company.
Overview
7
7
years of professional experience
9
9
years of post-secondary education
2
2
Certifications
1
1
Language
Work History
Case Manager, Medical Auditor, Medical Coder
Aster DM Healthcare
Dubai
05.2020 - Current
- Reviewed outpatient and inpatient records and interpreted documentation to identify diagnoses and procedures.
- Reviewed patient charts to better understand health histories, diagnoses and treatments.
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Accurately selected proper descriptive code when more than one anatomical location was indicated.
- Coded inpatient charts.
- Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
- Performed coding procedures for emergency room, impatient and outpatient services.
- Verified and checked medical charts for accuracy and completion.
- Consulted with clinicians to devise and manage ongoing care plans for at-risk patients.
- Trained doctors with respect to DRG, implementation of newer guidelines from DHA and insurance companies, medical rejections...
- Guided doctors in effective clinical documentation to impact the levels of severity to increase the revenue.
- Trained doctors with the appropriate ICD and CPT codes.
- Followed up the IP case records in order to extract missed diagnosis by the treating specialists and communicating the same with the doctors to improve the DRG weightage which further leads to improve in revenue.
- Updated the operations and billing teams regarding the cases going in loss on regular basis to prevent further losses in the revenue.
- Provided the requested initial and interim DRG to the approval team to get easy and early approvals.
- Conveyed the changes in the severity levels to the approval team following the discussion with the treating specialists.
- Responded to the queries from insurance companies with thorough justifications to prevent the rejections.
- Working on the medical audits cases and taking part in the audits.
- Reduced care costs without sacrificing quality through service coordination and multidisciplinary collaboration.
- Partnered with physicians, to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
BCLS instructor
JeevaRaksha Trust
05.2019 - 01.2020
- I have trained number of medical and non medical professionals and students from various hospitals and colleges.
- I have also directed the courses in this regard.
- I have performed well as a course dorector.
Consultant
Vivekananda Memorial Hospital
02.2018 - 05.2019
- I have been practicing ayurveda and providing consultation for out patients and taken care of inpatients.
- I have trained the therapists and students in panchakarma.
Post Graduate Scholar
Government Ayurvedic Medical College, Mysore
Mysore
11.2014 - 11.2017
Education
MD - Kayachikitsa - General Medicine
Rajiv Gandhi University of Health Sciences
11.2014 - 11.2017
BAMS - Ayurveda
Govt. Ayurvedic Medical College
08.2008 - 03.2014
Skills
Team Leadership & Development
Certification
Certified Medical Coder
Professional Certification Details
» Coding Guidelines
» CPT
» Medical Terminology
» HCPCS
» ICD – 10 CM
Software
Strengths
- Confident
- Punctual
- Self-motivated
- Positive thinking
- Enthusiastic initiator
Technical Skills
- MS Word
- MS Powerpoint
- Excel
Personnel Details
Date of Birth: 16 December 1990
Gender: Female
Nationality: Indian
Visa Status: Employment Visa
Timeline
Case Manager, Medical Auditor, Medical Coder
Aster DM Healthcare
05.2020 - Current
BCLS instructor
JeevaRaksha Trust
05.2019 - 01.2020
Consultant
Vivekananda Memorial Hospital
02.2018 - 05.2019
Post Graduate Scholar
Government Ayurvedic Medical College, Mysore
11.2014 - 11.2017
MD - Kayachikitsa - General Medicine
Rajiv Gandhi University of Health Sciences
11.2014 - 11.2017
BAMS - Ayurveda
Govt. Ayurvedic Medical College
08.2008 - 03.2014
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