MOHAMMED SAAD HASHIM
Insurance Officer | Healthcare Administration | Medical Insurance Specialist
Sharjah
Summary
A highly skilled and dedicated healthcare professional with extensive experience in medical insurance coordination and management. Proficient in handling insurance approvals, claims submissions, denials, and reconciliations using DHPO and Riayati PO systems. Adept at optimizing revenue cycle operations, conducting denial analysis, and ensuring compliance with MOH and HIPAA guidelines. Strong leadership and training skills with a proven ability to streamline processes and enhance operational efficiency. Insurance professional with comprehensive experience in managing insurance operations and driving continuous improvement. Proven track record of effectively leading teams to meet and exceed organizational goals. Known for strong analytical skills and adaptability in dynamic environments.
Overview
8
8
years of professional experience
9
9
years of post-secondary education
3
3
Languages
Work History
Insurance Manager
Shiyas & Ifthikar Medical Center
SHARJAH
06.2021 - Current
- Supervised the authorization process, ensuring timely and accurate submission of requests to insurance providers.
- Managed claims submissions, re-submissions, and reconciliations, ensuring accuracy and prompt payment processing.
- Conducted denial analysis to identify trends and implement corrective actions, reducing claim rejections.
- Oversaw the empanelment process, ensuring healthcare providers were properly registered with insurance networks.
- Trained doctors and staff on insurance procedures, coding, and system updates to ensure compliance and efficiency.
- Led the integration of new software tools, improving claims processing efficiency.
Insurance Co-ordinator
ASTER CLINICS, GROUP OF DM HEALTHCARE
DUBAI
09.2018 - 06.2021
- Managed outpatient and dental insurance approvals, ensuring timely follow-ups with insurance companies.
- Handled claims submissions, including paper claims and e-claims via DHA protocols.
- Prepared and analyzed denial reports, implementing new procedures to reduce future rejections.
- Conducted monthly reporting and provided insights to management for process improvements.
- Ensured compliance with DHA and MOH guidelines for all insurance-related activities.
CARDIAC PERFUSIONIST
TRAVANCORE HEART INSTITUTE, TRAVANCORE MEDICAL COLLEGE HOSPITAL
KERALA
08.2017 - 08.2018
- Assisted for cardiac perfusion for several cardiac cases
- Assisted as SCRUB NURSE in CARDIAC OPERATION THEATER
- Assisted for VEIN GRAFTING procedures in CARDIAC OT
- Postings in INTENSIVE CARE UNIT
- Postings in CARDIAC CARE UNIT
- Postings in CARDIAC WARDS
- Postings in CARDIAC OPD
- Postings in CATH LABS
Education
MEDICAL CODING -
CIGMA INSTITUTE OF MEDICAL CODING
INDIA 01.2018 - 12.2018
BSc. - CARDIO PULMONARY PERFUSION CARE TECHNOLOGY
KMCH Institute of Health Sciences
INDIA 01.2014 - 12.2017
XII - SCIENCE
T.K.M. C.P.S.
INDIA 01.2012 - 12.2013
X -
T.K.M. C.P.S.
INDIA 01.2010 - 12.2011
Skills
Audit coordination
Records management
Innovation skills
Risk analysis
Claims management
Industry trends
Risk management solutions
Teamwork and collaboration
Problem-solving
Operations management
Financial analysis and reporting
CORE COMPETENCIES
- Medical Insurance Management (DHPO & Riayati).
- Claims Submission & Re-submission.
- Denial Analysis & Resolution.
- Insurance Network Empanelment.
- Revenue Cycle Optimization
Special Knowledge
- CPT
- ICD-9/10
- CDT codes
- DDC Codes
- Denial codes
- E-claim & Riayati
- Coding Guidelines
- MOH guidelines
- Universal dental numbering
- Surgery and Modifiers
- Medical Terminology
- HIPPA Compliance
- Payment Methodologies
- HCPCS Level II
TECHNICAL SKILLS
- Coding Systems: CPT, ICD-9/10, CDT, DDC, HCPCS Level II.
- Software: E-claim, Riayati, DHPO.
- Compliance: HIPAA, MOH Guidelines.
- Medical Terminology & Coding Guidelines
Disclaimer
I hereby declare that the information furnished above is true to the best of my knowledge and belief.
Timeline
Insurance Manager
Shiyas & Ifthikar Medical Center
06.2021 - Current
Insurance Co-ordinator
ASTER CLINICS, GROUP OF DM HEALTHCARE
09.2018 - 06.2021
MEDICAL CODING -
CIGMA INSTITUTE OF MEDICAL CODING
01.2018 - 12.2018
CARDIAC PERFUSIONIST
TRAVANCORE HEART INSTITUTE, TRAVANCORE MEDICAL COLLEGE HOSPITAL
08.2017 - 08.2018
BSc. - CARDIO PULMONARY PERFUSION CARE TECHNOLOGY
KMCH Institute of Health Sciences
01.2014 - 12.2017
XII - SCIENCE
T.K.M. C.P.S.
01.2012 - 12.2013
X -
T.K.M. C.P.S.
01.2010 - 12.2011
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