MEHAR UN NISA
Billing And Insurance Manager
Doha
Summary
A Medical Billing and Insurance Manager is responsible for overseeing the billing processes related to insurance claims and ensuring accuracy, efficiency, and compliance with insurance regulations and company policies. This role involves managing claims team, billing team, reconciliation team coordinating with internal departments (such as pre-approval team, pharmacy , and reception ), and interacting with insurance providers to ensure timely and accurate billing for insurance premium, claims, and related services.
Overview
13
13
years of professional experience
3
3
Languages
Work History
MEDICAL BILLING AND INSURANCE MANAGER
TURKISH HOSPITAL
08.2023 - Current
- Handling total 23 (METLIFE,MEDCO,MEDNET,QLM,ALLIANZ,NEXTCARE,GLOBEMED,GIG,BUPA,MSH,ALKOOT,CIGNA,AETNA,INTERNATIONAL SOS,NAS &NEURON,TRICRAE,AXA INTERNATIONAL,SOS INTERNATIONAL,EURO CENTER,EURO ASSISTANCE,IOM,LGA,MOPH GAZA)insurance companies and upcoming project National Insurance and complete all coding according to MOPH guidelines with ICD 10 CM 2025,CPT/HCPCS 2024,QNDC,QSL.
- Oversee the end-to-end billing process for insurance premiums, claims, and policy adjustments.
- Ensure that all invoices and bills are processed accurately and in a timely manner.
- Generate monthly reports on claims reconciliation status, outstanding balances, and payment trends for management review.
- Conduct regular audits of the billing process to identify inefficiencies and recommend solutions.
- Prepare regular reports on billing operations, including aging reports, payment history, and outstanding accounts.
- Monitor and report on billing performance metrics, identifying trends, inefficiencies, or areas for improvement.
- Work closely with the claims department to ensure accurate billing of claims and proper adjustments in case of disputed charges.
- Address and resolve any customer complaints related to billing errors, claims payments, or premium amounts.
- Manage the reconciliation of payments received against billed amounts, ensuring that all payments are applied accurately.
- Investigate discrepancies between billed amounts and payments, working with claims and underwriting teams to resolve issues.
- Develop training programs for the billing team to improve accuracy, efficiency, and customer service.
- Educate healthcare providers and staff on insurance policies and claim submission processes.
MEDICAL BILLING MANAGER
GLOBAL CARE HOSPITAL -AL HILAL EMPLOYMENT SERVICES
01.2018 - 12.2022
- Develop and maintain standard operating procedures for billing processes to ensure consistency and accuracy.
- Ensure that all billing transactions are properly recorded and updated in the accounting system.
- Manage and supervise the billing team, assigning tasks, setting performance goals, and monitoring workload.
- Coordinated between medical staff and patients to ensure timely and effective care delivery.
- Verify patient insurance coverage, ensuring accuracy for billing purposes, and assist patients in understanding their benefits.
- Process patient check-ins, collect necessary documentation (ID, insurance, medical history), and confirm appointment details.
- Manage patient flow, ensuring timely check-in/check-out processes and minimal wait times for patients.
- Handle medical billing inquiries and process payments for co-pays and outstanding balances.
- Prepare and present regular reports on billing activities, including accounts receivable aging reports, revenue, and payment statuses.
ASSISTENT MEDICAL BILLING MANAGER
AL WAHDA MEDICAL CENTER-REACH EPLOYMENT SERVICES
01.2014 - 11.2017
- Coordinate and manage pre-authorization requests for medical treatments, procedures, and medications to ensure timely approvals and efficient patient care.
- Implement best practices and standard operating procedures for billing operations, ensuring efficiency and reducing errors.
- Work directly with healthcare providers to gather necessary medical documentation and submit pre-authorization requests to insurance companies.
- Lead and supervise a team of billing specialists and clerks, providing guidance, training, and support.
- Review patient insurance policies to confirm coverage eligibility and determine the necessary documentation for pre-approval.
- Communicate with insurance companies to resolve issues or delays in obtaining pre-approvals for medical procedures, treatments, and prescriptions.
- Track the status of pre-approval requests and follow up with insurance companies and healthcare providers to expedite approvals and avoid delays.
- Assign tasks, set performance goals, and monitor the productivity and performance of the billing team.
- Assist with audits related to billing and insurance claims, providing necessary documentation and addressing any issues raised.
- Provide senior management with insights into billing operations, revenue, and outstanding issues.
- Advise medical professionals on insurance policies and necessary documentation for claim approvals.
BILLING ASSOCIATE
REACH EMPLOYMENT SERVICES
03.2012 - 12.2013
- Generate and prepare accurate invoices for products or services provided, ensuring proper billing codes and payment terms are applied.
- Verify that all billing information is correct, including customer details, products/services rendered, quantities, and pricing.
- Respond to customer inquiries regarding their bills, providing clear explanations and resolving any issues or discrepancies.
- Maintain positive relationships with clients through prompt and helpful communication.
- Maintain organized and secure billing records to prevent errors and facilitate easy access when needed for audits or reporting.
Education
MBA -
Punjab University
Lahore, Punjab 04.2001 -
Bachelor of Science -
Gulberge College
Lahore, Punjab 04.2001 -
Skills
Medical Pre-authorization & Pre-approval Process
Timeline
MEDICAL BILLING AND INSURANCE MANAGER
TURKISH HOSPITAL
08.2023 - Current
MEDICAL BILLING MANAGER
GLOBAL CARE HOSPITAL -AL HILAL EMPLOYMENT SERVICES
01.2018 - 12.2022
ASSISTENT MEDICAL BILLING MANAGER
AL WAHDA MEDICAL CENTER-REACH EPLOYMENT SERVICES
01.2014 - 11.2017
BILLING ASSOCIATE
REACH EMPLOYMENT SERVICES
03.2012 - 12.2013
MBA -
Punjab University
04.2001 -
Bachelor of Science -
Gulberge College
04.2001 -
Languages
ENGLISH
HINDI
URDU
Qid No
27758605379
Personal Information
- Date of Birth: 05/03/77(46 years)
- Nationality: PAKISTAN
- Valid Qatar Driving License
Qid No
27758605379
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