Passionate Case manager with Senior-level experience of nearly 15 years, combined of clinical and insurance. Specialised in case management, auditing, Pre-authorization(IP) claims, and reimbursement. Independent problem-solver focused on customer service and product development. Seeking opportunity to work in an established company.
Case Management, Field Audit, FA, DRG negotiation, Audit on HVC, Cost containment.
Handling Pre-authorisation(IP), claims, reimbursement,
SMOs, case management and payer escalation.
Designed and reviewed effective end-to-end authorisation and risk management frameworks.
Analysed and evaluated the efficacy of current risk management cultures, implementing improvements as
required