Overview
Work History
Education
Skills
Languages
Appreciation
Certification
Timeline
Generic
MOHAMED SHAMEERUDEEN

MOHAMED SHAMEERUDEEN

DUBAI

Overview

10
10
years of professional experience
1
1
Certification

Work History

Executive Insurance Co-ordinator

Medcare Royal Speciality Hospital
07.2024 - Current
  • Processed initial DRG assignments across all specialties, working closely with clinical teams to ensure accuracy and compliance coding.
  • Conducted in-depth DRG severity analysis to validate case complexity and support appropriate reimbursement.
  • Facilitated the revision and reassignment of DRGs to align coding with the latest clinical documentation, procedures, and diagnoses.
  • Coordinated and progressed elective cases across multiple specialties, ensuring timely insurance approvals and streamlined workflow.
  • Proactively monitored insurance claims, resolving DRG-related disputes, minimizing denials, and supporting smooth revenue cycle operations.

Senior Associate -RCM

Aster Hospitals
04.2021 - 06.2024


  • Well-versed with medical terminologies and have good knowledge of CPT and ICD guidelines.
  • Managing the DRG query process, collaborating with clinical staff and healthcare administrators to clarify and validate documentation for accurate DRG assignment.
  • Working with multispecialty healthcare units and specialized in oncology and hematology.
  • Providing necessary information to patients about health insurance policies Preparing, sending, and updating the status of pending approvals for both outpatient and Inpatient procedures (IP-DRG/DC DRG/FFS).
  • Monitor the status of pending approvals and follow up with payers to expedite the process.

Junior Team Leader

SCYO Decision Service Pvt Ltd
02.2015 - 02.2021
  • Manage end-to-end revenue cycle processes including charge capture, coding, billing, and collections.
  • Review and analyze billing data to identify and rectify revenue leakage opportunities.
  • Collaborate with healthcare providers and coding team to ensure accurate coding and documentation for proper reimbursement.
  • Implement process improvements to optimize revenue cycle workflows and reduce denials.
  • Resolved billing discrepancies and denials, ensuring timely payment and revenue maximization.
  • Conducted insurance eligibility verification and pre-authorization for medical services.
  • Initiated authorizations for oncology, oncology gynecology, and radiation therapy services, ensuring timely access to specialized care.
  • Handled claims denials, rejections, and no-response work queues, conducting thorough follow-ups, reviews, and documentation.

Education

BE -Electronics and Communication Engineering. -

Kings College Of Engineering
Tamilnadu,India
2014

Skills

  • Medical Billing -RCM
  • IP DRG
  • DRG analysis expertise
  • Certified Professional Coder(CPC)
  • Day-case DRG
  • Proficient in 3M applications
  • FFS
  • Proficient in medical language
  • Insurance Verification
  • ICD-10 coding expertise
  • Healthcare coding expertise
  • Team management

Languages

Tamil
Proficient
C2
Malayalam
Intermediate
B1
Hindi
Intermediate
B1
English
Bilingual or Proficient (C2)

Appreciation

  • Awarded best employee of the month.
  • Awarded best employee of the year.

Certification


AAPC CPC Certified Member# 02351541

Timeline

Executive Insurance Co-ordinator

Medcare Royal Speciality Hospital
07.2024 - Current

Senior Associate -RCM

Aster Hospitals
04.2021 - 06.2024

Junior Team Leader

SCYO Decision Service Pvt Ltd
02.2015 - 02.2021

BE -Electronics and Communication Engineering. -

Kings College Of Engineering

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