MD TECH
Supervisor Special Projects – Eligibility, Referrals, Authorization, Coding and clinical side (Nov 2017- To Date)

Responsibilities:
 Interpret medical information such as diseases or symptoms, and diagnostic descriptions and procedures for a given visit in order to accurately assign and sequence the correct ICD, CPT and modifiers.
 Responsible in making sure the assigned codes meet all federal, legal and insurance regulations so service payments are obtained in a timely fashion
 Capable of organizing, compiling and translating the medical treatment information.
 Evaluate and validate all codes various coding services and provide accurate procedures and evaluate all codes for all processes.
 Worked for couple of Cardiology Centers for processing the technical pre-auth requests.
 Worked closely with peer to peer cases or medical records review cases with insurances medical directors to get those approved.
 Designed workflow and basic guidelines for the clients and team as well.
 Introduced a tracking process for authorizations and referrals
 Worked with a big radiology center for 15 radiologist and helped them to maintain streamlined processes for referrals, authorization and
 Managing a team of 08-10 resources for eligibility and authorization process for 6 different clients.
 Training of new comers and mentoring the experience resources as per ongoing updates in the industry and from clients.
 Guiding team for insurances eligibility verification and money calculations
 Maintaining a great communication with all clients, handling not only daily, weekly and monthly meetings but also providing them best reports to keep them abreast of their business.
 Help the company to establish Authorization/Referral/Eligibility department and trained the resources to understand the clinical queries.
 Pharmacy background with strong Clinical knowledge.
 Expert in handling team in professional manners.
 Deal with special projects such a

• Performing medical record review for physician offices based in USA remotely
• Reviewing assigned medical records in order to abstract specified and required clinical data elements for Patient Quality reporting
• Ability to communicate information and ideas clearly, concisely in writing; read and understand information presented in writing
• explore alternatives, and propose quality solutions
• gathering and collecting information or data
• work independently once oriented to routine and process.
• Have proficiency with Microsoft Office applications including Word, Excel, Power Point.
1 E-clinical Work
a e-prescriptions
b Diagnosis
c Labs reports
d Medicine Adherence
• 2 Training on HCC Coding
Successfully completed Training on HCC Coding
• 3 PCMH ( Patient Centered Medical Home services )
Prepare Patient Care plans for Diabetic , Asthmatic , and for Hypertensive Patients
• 4 Lab Accessioning ECL ( Empire city Lab )
Trainer for Lab Accessioning
• 5 Guidelines To AR Team for proper Diagnosis Codes ICD 10
• 6 Quality Control Analyst ECL ( Empire City Lab )

Assistant Manager (April 2014 – Nov 2015)

Achievements:
 Successfully provided medication advice to a diverse range of customers every day
 Undertook Quality Assurance Project on OTC Counseling
 Demonstrated good problem-solving skills in pharmacotherapeutics and administration

Responsibilities:

 Assign staff to specific duties
 To provide customer service by greeting and assisting customers, and responsible to customer inquiries and complaints
 Direct and supervisor staff engaged in sales, inventory-taking, reconciling cash receipts, or in performing services for customers.
 Instruct staff on how to handle difficult and complicated sales.
 Responsible for product development & sourcing.
 Arrange the space new products.
 providing advice about health issues, symptoms and medications in response to customer enquiries
 recruiting, training and managing staff
 processing prescriptions and dispensing medication
 ordering, selling and controlling medicines and other stock
 meeting medical representatives
 managing budgets, keeping statistical and financial records
 preparing publicity materials, displays and handling marketing services




Internships:

Fazal Dins Pharma Plus Lahore Pakistan (26-09-2012 26-01-2013)
Trigon Pharma (pvt) Ltd. Lahore Pakistan (01-07-2011 31-08-2011)


Certificates:

 Registered Pharmacist from Punjab Pharmacy Council Lahore Pakistan (Registration # 9663A ) ( Licensed # 1245/9)
 Certificate of participation Current Pharmacy Practices
 Certificate of participation at international pharmacist conference
 Passed SCH QATAR exam with 77%
 Successfully completed course for CPC