Mohammed Ali

About Mohammed Ali

EXPERIENCE Cognizant Technologies Jun 2016 - Present Senior Associate Hyderabad IndiaCurrent Designation-Senoir claims Associate or Account receivable Analyst.Responsibilities:• Review provider claims that have not been paid by insurance companies• Worked on the Aging Accounts of 90+ and 120+ Accounts and claims.• Calling to insurance companies on behalf of Doctor’s for the bill and Claim status after patient rendered the service from doctors & Need to follow up on the claim with the insurance office.• Follow up with insurance companies to understand status new and denied claims. Follow up is done through insurance company website or through outbound calls• Good Knowledge Denials Claims.• Having Knowledge of Medical Groups and Health insurance Companies.• Based on information received from the insurance company, make necessary corrections to the claim and re-file the corrected claim to the insurance company.• Knowledge of commercial insurance, Medicare, Medicaid, worker comp and other payer also.• Worked on the Application software i.e Kareo, Project Management(PM),Imagine, RTK Tool.• Worked on the different Specialties i.e Physical therapy, Radiology, Dermatology, POM MRI.• Knowledge of Clearing houses i.e Trizetto, Office Ally, Gateway EDI, Emdeon.• In case the patient does not have sufficient insurance coverage for the medical procedure or if the patient is in any way not eligible for coverage, transfer the outstanding balance to the patient.• In case the claim has already been paid by the insurance company, request insurance company to send EOB (Explanation of Benefits) through fax/ mail.• Receive Appreciation certificates multiples times for the best Employee of month.• Worked on Enterprise Practices and also worked on Client and Escalation emails.HealthCare Productivity Automation(HPA)• Knowledge of Preparing Detailed Workflow document for Automation Process in HPA Capture Tool, So it would be easy for Coding Development team to understand and make the Process into automation easily.• Worked with Coding Development Team to make the Manual Work into Automation Process & Providing All input, Support and Detail which Help them to Convert the manual work and repetitive task into automation.• Worked with Development team to make the Appeal Process into automation.• Able to Prepared the Workflow Document for Different process as well which will require to convert into Automation.

Experience

1. Process Specialist

   Cognizant

   Jun 2016 — Present · Hyderabad, IN

   Working as a AR CALLER,•Calling to insurance companies on behalf of Doctor’s for the bill and claim status after patient rendered the service from doctors & Need to follow up on the claim with the insurance office with payer like Medicare,medicaid and commercial payer!

Education

• Jawaharlal Nehru Technological University

  Bachelor of Technology, Electrical Electronics and Communications Engineering

  2012