Nada Modan

• Monitored and reviewed Insurance and corporate contracts across all My Clinic branches.
• Monitored and reported contract performance against KPIs and requirements, ensured compliance with stated terms and conditions mentioned, identifies and flags any violations and undertakes necessary corrective measures.
• Planed and executed RCM audits in accordance with department standard policies and procedures.
• Analyzed and evaluated data to extrapolate trends, potential risks, identified and flagged inconveniences and/ or violations. developed practical solutions and driven actions to improve controls and mitigate risks.
• Analyzed and optimized the entire revenue cycle, identifying opportunities for process improvements to accelerate reimbursement and reduce denials, collaborating with billing and finance teams to streamline revenue cycle workflows.
• Assessed RCM business risks and evaluated internal controls to provide RCM repeatable model.
• Reviewed and pressure-tested RCM end-to-end processes, identified redundancies and bottlenecks, flags showstoppers and gaps, collaborated with involved internal & external stakeholders for proper process compliance, and worked accordingly on enhancing and revamping the processes whenever required.

• Worked with RCM director to implement new policies, procedures and controls.
• Identified areas in need of critical improvement and implemented strategies to achieve monthly and quarterly revenue targets.
• Developing effective Revenue Capture processes and procedures to maximize monthly revenue.
• Managed all contracts and POs of Insurance companies and external corporate companies.
• Worked with Risk Management Department in internal and external RCM audits and conducted technical reviews of current processes and procedures.
• Worked with Marketing Department to create high value campaigns.
• Led Monthly RCM department meeting and checklists.

Pre Authorization - Medical Coding.