Mohammed Niyas. Kakkattil
Health Claims Specialist / Preauthorization Coodinator
Summary
Well experienced Health Insurance Specialist & Preauthorization Coordinator. Expert in processing , submitting and resubmitting of Insurance Claims.Good knowledge of Generic Names of Medicine ,Medical Terminology, PBM, Medical Coding, Medical Billing.
Organized, driven and adaptable with excellent planning and problem solving abilities. Offering 6+ years of experience and willingness to take any challenge .
Overview
10
10
years of professional experience
6
6
years of post-secondary education
Work History
Health Insurance Specialist
Hiba Asia Healthcare Group
Jeddah
01.2013 - Current
- Managed modifications by detecting and correcting coding errors, decreasing error rates .
- Contacted insurance companies to discuss and resolve unpaid claims and incorrectly paid claims.
- Displayed consistent, positive attitude towards patients, and other personnel, even during high-stress situations.
- Maintained consistent follow-up on status of prior authorization requests.
- Reviewed authorizations from payer to determine approved or denied items.
- Calculated estimated copay based on current insurance benefits.
- Communicated with executives about consistent customer issues.
- Gathered records pertinent to specific problems, reviewed for completeness and accuracy and attached records to correspondence as necessary.
Education
Bachelor of Arts - English Language And Literature
University of Calicut
04.2008 - 03.2011
Biology Science
GGHS (Plus Two)
Perinthalmanna,Kerala 04.2004 - 03.2006
Ass.Pharmacy
BSS
Angadippuram, Kerala 04.2007 - 03.2008
Medical Coding
Arrown Academy
Perinthalmanna,Kerala 09.2021 - 12.2021
Skills
Risk mitigation
undefinedTimeline
Medical Coding
Arrown Academy
09.2021 - 12.2021
Health Insurance Specialist
Hiba Asia Healthcare Group
01.2013 - Current
Bachelor of Arts - English Language And Literature
University of Calicut
04.2008 - 03.2011
Ass.Pharmacy
BSS
04.2007 - 03.2008
Biology Science
GGHS (Plus Two)
04.2004 - 03.2006
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