Saqib Ali

Saqib Ali Team Lead Operations (RCM) Cell # - Skype#- Email:- Skype Link# https://join.skype.com/invite/opNl15x83f7M Address: Bangash Plaza flat#04 dhoke kashmiriyan, Rawalpindi, Punjab, Pakistan. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- Objective: Seeking a position at a reputable healthcare organization where I can utilize my expertise in coding, billing processes, and insurance claims to enhance operational efficiency and ensure accurate reimbursements and help the company achieve business goals while sticking to the vision, mission, and values of the organization. Work Experience: Prime DOC Billing LLC (Feb 2023 - Present) Team Lead Operations • • • • • • • • • • • • Assist and manage overall operations of the floor. Managing Kick-off calls and provides all the necessary data to the team to kick start the billing for new clients. Practice assessment for new clients and auditing the practices on monthly basis for all the ongoing clients. Attends weekly and monthly meetings with clients to provide them overall review of the practice. Develop and implement management controls and quality assurance processes to ensure the accuracy and efficiency of claims submission, payments postings and Account Receivable. Exhibited extensive knowledge of Managed Care, Medicare, and Medicaid industries with an understanding of importance under recent healthcare reform. Monitored and reported productivity and worked collaboratively with Manager Operations on periodic audits. Provided ongoing education to Billing staff and Midlevel Practitioners covering changes in billing and reimbursement rules, state and federal legislation, and billing software applications. Managed physician fee schedules and updates system according to provider type, and respective payer/intermediary reimbursement levels. Responsible for Creation of revenue reports by the department on a daily, weekly and Monthly basis. Supervised of all business office functions including customer service, insurance verification, financial counseling, medical records, account follow-up and collections, and Payment posting. Research, analyze, and respond to inquiries regarding medical coding, billing denials, and billable services. Billing Executive at PMTAC • • • • • • • • • (Dec,2021-Sep 2022) Successful execution of all operational aspects related to Insurance Claims, Denials and Accounts Receivable. Contacted insurance companies and third parties’ payers regarding errors and discrepancies. Resolved errors by resubmitting corrected or unacknowledged claims, medical records, appeals and other documentation required for timely payments. Issued refunds as needed. Educated in Medical Terminology, EOB's, Remittances, CPT and ICD’s. Worked independently and as a team member. Assist with cash application and billing at months and year ends when needed. Discovered and led a project to recover funds paid to patients once it was determined insurance companies were issuing payment to the members in an early-stage company. Worked on receivables and identified improper payments, inappropriate claim denials, billing errors and discrepancies on all returned claims through final resolution. Care Cloud (MTBC) (Feb,2020-Nov,2021) Account Manager operations • • • • • • • • • Independently manage all activities of the medical billing cycle of assigned clients. Efficient Revenue Cycle Management (RCM) of the assigned clients to establish and maintain positive, longterm relationships with clients. Timely and error free medical bills entry and posting of the reimbursements received from insurances. Ensuring client satisfaction by an effective and regular follow-up on accounts receivables. Swift and accurate remedial actions on claims denied by healthcare insurances. Independent and timely communicate with insurances to ensure steady stream of clients’ cash flow. Independent and regular communication with client and his office staff including prompt response to their queries and concerns. Understanding of relevant Key Performance Indicators (KPIs) and working towards positive results for the assigned clients against all KPIs. Striving for optimum utilization of company resources on the assigned clients and suggesting areas of improvement. Keeping the immediate supervisor aware of all important issues of assigned clients. Ensure compliance with information security responsibilities specific to job role. Command On Software’s: (eCW, Nextgen, Advanced MD, Office Ally, Kareo (tebra), Athena, Zhealth, Dr. Chrono, CGM (Aprima), Intergy, RXNT, CMD, Simple Practice, Therapy appointment, Optimantra) Specialties Worked: (Internal Medicine, Family Medicine, Cardiology, Orthopedics, Mental health, Physical therapy, Chiropractic, Gastrology, Podiatry) Qualification: ➢ B.Sc. in Electrical Engineering- (Comsats University Islamabad) Certifications: ➢ Nebosh ➢ IOSH Command on Languages: ➢ Well versed in: o English o Urdu o Punjabi Computer Skills: ➢ MS word, Excel, Power Point. References: (Will be provide upon request)