Mohammad Naiyaz Uddin

MOHAMMAD NAIYAZUDDIN EMP Install Rep Mobile: - Email ID:- Career Objective: Seeking a position as a Caregiver with Care Solutions where I may be able to assist patients in leading a dignified life by helping them with basic needs and medication. Professional Summary: Having around 7 Years of experience in Health Care. Code the Insurance benefits for different health care services of the employer. Excellent problem-solving skills with a strong healthcare background. Strong knowledge in Medical Billing. Also worked as assistant trainer as well as floor support to the newly joined teammates. Maintaining good quality as well as productivity and attendance. Received monthly R n R Awards for production and Quality. Analyzing and preparing TAT and QA reports as per onshore requirement Effective in working independently and collaboratively in teams. Skills: Operating Systems Windows 95/98, Windows 2000 / 2003, Windows XP, Win 7,10 Domain Knowledge Auto Adjudication, Medical Billing, Health Care Special skills MS. Office, E-mail writing Education: B.Sc. from Apoorva Degree College from Kakatiya University Institute Karimnagar. Work Experience: Process #: TOPSTeam Member: Feb/2016-Till Date Process Domain Insurance Client United Health Group Organization OPTUM GLOBAL ADVANTAGE Team Size 30 Environment UNET, Auto Adjudication Roles & Responsibilities: Code the Insurance benefits for different health care services of the new customer as well as existing customer in the UNET application. Benefits are like several health care services & related to Coins, Copay, Deductible, OOP & Physician visit limits etc. Benefits have been code based on the SOTs like benefit summary, State Mandates Law, special processing instruction summary and other documents and in the form of several procedures like SVC, CPT and Cause codes. There are different funding types for a particular case like FI (Fully insured services) & ASO (Administrative services only) under several transaction types like New Business/Renewal/ Maintenance. If the benefit is coded correctly in the UNET application, then claims paid through the Auto Adjudication process. Once the coding done for a particular customer then the case has been assigned for the Benefit validation testing and Quality team. As a responsible team member, I attend daily onshore calls which are related to Process updates, production, quality & nonstandard scenarios and same has been shared around the team. Process #: SBCTeam Member: Mar/2017 – June/2017 Process Domain Insurance Client United Health group Organization OPTUM GLOBAL ADVANTAGE Environment Summary Benefit of Coverage Team Size 35 Process Description: The process of the Summary of Benefits and Coverage (SBC) is to provide Individuals with standard information so they can compare medical plans as they make decision About which plan to choose. It is a word document which is contain 8 pages and explain about The policy details to the customer, it came into force by “OBAMA CARE” in Sep 2012.SBC follows Federal law and state mandates. Process #: BVTTeam Member: Aug/2015-Feb/2016 Process Domain Insurance Client United Health group Organization OPTUM GLOBAL ADVANTAGE Environment Testing Macros, CVT TOOL Team Size 8 Roles & Responsibilities: Currently working as a Claim Tester for the process TOPS (The online processing system). Where my responsibility to test the claims of employer for Both National & Key Account. I test the claims with different funding types like Fully insured services & Administrative services under several transaction types like New business/Renewal/Maintenance with the help of UNET application. I test the claims for both onshore/offshore Benefit coding analyst based on the SOT’s like benefit summary, State Mandate law, SPI’s. I need to create scenarios manually for each service which falls under the case or the benefit category and test the claims. If I got any error in testing, then I lock the issues by using BVT Tool. After testing completed for a particular customer then the case has been re-assigned to the coder queue. Working on the aged inventory to complete those with in the TAT and doing over time as per business requirement. Sharing ETA report and daily production report of the team across the business. Attend onshore calls in a regular basic where we discuss about process and production details. Also worked as an assistant trainer as well as floor support to the newly teammates. Team Member: Dec/2013-May/2015 Process #: Process Associate Process Domain US-Insurance Client Phycare Organization R29 Solutions (p) Ltd. Team Size 40 Personal Information: Name: Mohammad Naiyaz Uddin Father’s Name: Mohammad Masiuddin Address: D No. 16-9-654/1/D/1 Old Malakpet, Hyderabad, T.S, India Date of Birth: - Language Known: English, Hindi, Urdu, Telugu. Passport Details: W- - to-) Declaration: I hereby declare that the information furnished above is true to the best of my knowledge. Thanking You, Mohammad Naiyaz Uddin