Summary
Overview
Work history
Education
Skills
Websites
Certification
Accomplishments
DECLARATION
PROFESSIONAL KNOWLEDGE
Languages
Affiliations
References
Timeline
Generic
Nimitha Elsa Philip

Nimitha Elsa Philip

Ras Al Khaimah,UAE

Summary

Detail-oriented professional with expertise with 9 year of experience as Medical coder and Insurance coordinator in healthcare systems, including eClaim, Riayati, HIS, and EMR. Proficient in coding systems such as ICD-10-CM, CPT (AAPC Certification), and dental coding standards. Skilled in utilising software tools like Microsoft Office to streamline processes and ensure accuracy. Committed to leveraging technical knowledge and analytical skills to enhance operational efficiency within the healthcare sector.

Overview

15
15
years of professional experience
1
1
Certification

Work history

Senior Dental Medical Coder / Insurance Coordinator

Smile Care Medical Center
Ras Al Khaimah
2017.07 - 2026.06
  • Assign accurate dental procedure codes based on clinical documentation and payer guidelines.
  • Verify patient eligibility, benefits, policy coverage, exclusions, and co-pay requirements.
  • Process prior authorizations and obtain approvals for dental procedures.
  • Prepare, review, validate, and submit claims through eClaim and Riayati platforms.
  • Ensure all supporting clinical documentation is complete before submission.
  • Monitor submitted claims and follow up until reimbursement is received.
  • Investigate claim denials, prepare appeals, and coordinate corrective actions.
  • Liaise with insurance companies regarding network-related concerns and provider updates.
  • Generate reports related to claims, authorizations, collections, and outstanding balances.
  • Ensure compliance with UAE healthcare and insurance regulations.
  • Alleviated administrative burden from practitioners by taking responsibility for accurate medical coding.
  • Enhanced revenue cycle management via efficient identification of billable services.

Nursing Educator

Sana College of Nursing
Hubli
2011.01 - 2014.08
  • Delivered classroom and clinical teaching to undergraduate nursing students.
  • Developed and updated nursing curriculum in line with academic and healthcare standards.
  • Supervised and evaluated students during clinical training in hospital settings.
  • Assessed student performance through exams, practical evaluations, and assignments.
  • Provided mentorship, academic guidance, and career counseling to students.
  • Implemented innovative teaching strategies including simulations and case-based learning.
  • Key Responsibilities

Education

Master - Medical & Surgical Nursing

Shridevi College of Nursing

Bachelor of science - Nursing

Ramakrishna college of nursing

Skills

  • Healthcare Systems: eClaim, Riayati, HIS, EMR
  • Coding Systems: ICD-10-CM, CPT (AAPC Certification), Dental Coding Standards
  • Software: Ms Office

Certification

  • Medical Coding Certification (AAPC Certified Medical Coder (CPC) , ICD-10, CPT, and HCPCS coding systems
  • Dental Coding Training

Accomplishments

  • Improved claim acceptance rates through accurate coding and claim validation.
  • Reduced claim rejection and denial trends through root-cause analysis.
  • Enhanced authorization turnaround times through proactive insurer communication.
  • Supported efficient revenue cycle processes and reimbursement performance.

DECLARATION

I hereby declare that the information provided above is true and correct to the best of my knowledge and belief. Nimitha Elsa Philip

PROFESSIONAL KNOWLEDGE

Extensive knowledge of UAE insurance regulations, dental billing procedures, claims adjudication, eligibility verification, prior authorization processes, denial management, network administration, revenue cycle management, eClaim validation rules, and Riayati submission requirements.

Languages

English
Proficient (C2)
Malayalam
Proficient (C2)
Hindi
Advanced

Affiliations

  • Reading

References

References available upon request.

Timeline

Senior Dental Medical Coder / Insurance Coordinator

Smile Care Medical Center
2017.07 - 2026.06

Nursing Educator

Sana College of Nursing
2011.01 - 2014.08

Master - Medical & Surgical Nursing

Shridevi College of Nursing

Bachelor of science - Nursing

Ramakrishna college of nursing
Nimitha Elsa Philip