LAMNGANBI THOKCHOM

Responsibilities: • Coordinate with UAE insurance companies for clinic empanelment • Manage documentation, licensing and compliance process for new insurance contract/partnership • Handle insurance rate negotiations, send email for Dr’s license addition to respective insurance provider and registration in insurance portal • Obtain prior-authorization approval through DHPO & insurance portal • Assign correct ICD code and CPT as per coding guidelines • Reduced claim rejection by providing accuracy and compliance with insurer guidelines • Improved claim approval rate by ensuring proper coding and documentation • Coordinate with doctors and nurses to resolve insurance related discrepancies • Billing by checking auth. code, diagnosis, auth validity, billing amount • Thorough review on doctor documentation (SOAP) which are essential for clinician professionals and coordinate accordingly • Obtain prior-authorization for Home Care Nursing & Home Care Physiotherapy (NEXTCARE, ALMADALLAH, NAS) • Billing Home Care Nursing, Physiotherapy and Claim submission after proper documents review.

Responsibilities: • Download remittance advices from insurance payers and complete review on rejected claims • Check the reasons for any denials and apply the necessary corrections and medical justifications • Review the price list and contract terms with payer if rejection is related to the same • Attach relevant supporting medical document and submit to the insurance payer for re-evaluation. Pre - Approval Coordinator IP & OP Responsibilities: • Submit insurance approval request through DHPO, insurance portal and email • Creating IR-DRG through 3M code-finder • Coordinating with the insurance agency for travel insurance member patient (LGA) • Taking approvals for dental services • Check insurance eligibility • Assign ICD & CPT code as per AMA coding guidelines • Obtain approval by submitting support medical documents and justification

Responsibilities: • Coordinate with the Doctors, Insurance team, Pharmacy, Billing and Medical Coders on daily basis • Resolved discrepancies for insurance-related issues • Submit a supporting medical report, justifying to get insurance approval • Facilitate discharge process and minimize the gap/delay by implementing strategy • Analyst monthly discharge data and submit to case management director

Responsibilities: • Assist patient with their insurance coverage, policy and benefit • Take insurance approval for our valued patient through DHPO, email and insurance • Coordinating with the doctors and nurses regarding required medical report to justify medical necessity treatment of the patient • Inform the insurance status to the concern department/patient Cashier Responsibilities: • Ability to work in all OPD, i.e. OBGYN, DENTAL, Radiology, ED, General Surgeon, IM, etc. Patient’s registration and billing • Received calls and book an appointment for a patient • Multi task performer at a time