SAIRA KARIM
Cincinnati,OH
Summary
Seeking a challenging role where I can leverage a diverse background and skill set, including an MBA and MD degree with ECFMG certification, coupled with extensive experience in hospital settings. Proficient in medical terminology, clinical documentation, and interpretation, I aim to apply these skills in project management. My ideal position involves a blend of financial analysis, Medicare/Medicaid customer communication, and technical expertise. As a goal-oriented individual, I bring a strong understanding of client needs, urgency, and effective task prioritization to the table.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Financial Analyst
Anthem
06.2021 - 12.2023
- Conducting financial analysis utilizing Excel, including 'What If' analysis and VLOOKUP, and advanced statistical software like SSRS and Tableau reporting
- Managing Financial concepts, payment processing, account balancing, delinquent account management, and client education on administrative fees
- Coordinating with sales and underwriting teams for rate setups and ensured accuracy in Financial products and associated processes.
- Managing Approximately 20-25 calls or emails per day by clients to resolve the issues
Grievance Analyst
Anthem
02.2021 - 05.2021
- Able to review, analyze and process grievance requests by member related to Part C and D in timely manner
- Proficient working with Facets to find out claims/ denials and providers network status search to resolve grievance issues
- Confident using HIPAA tools like CIRS to maintain HIPAA confidentiality.
Member Service Representative II
Anthem
12.2018 - 01.2021
- Demonstrating customer service skills, such as using strong listening skills, memory retention abilities, and being able to relay information accurately, completely, and sufficiently with excellent communication skills
- Help problem solving with colleagues, in claim handling or premium payments issues to efficiently supply to customer's needs
- Simplifying plan benefits to new members to understand copayments and coinsurance
- Exhibiting good skills in provider relations during t authorization process before inpatient service.
- Always staying on top 1st position for customer surveys and scored 95% on FCR First Call Resolution
Medical Interpreter
Cincinnati Children's Hospital
05.2017 - 12.2018
- Delivering real-time, accurate oral translations and interpretations for clients
- Bridging communication barrier bet patients and medical staff and simplifying complex medical terminologies
- Assisting management team to follow compliance for best outcome for patients
- Reducing patient hospital stay from 12 days to average 6-7 days during job with CCH.
Education
MBA - Health Care Business Administration
University of Cincinnati, Lindner College of Business
Cincinnati, OH08.2018
Doctor of Medicine (MD) -
ECFMG
Education Commission For Foreign Medical Graduate10.2012
Skills
- Ability to using Regression Tools with What-If analysis
- Ability to effectively comprehend graphic interpretation of data
- Analytics: IBM Watson
- Palisade Risk 75
- Global DNA: Capstone, Business Development Simulation
- Citrix, Facets, Maces
- Appeal Processing: Next Gen
- Payment & Invoice tools: Trans centra
- E portal
- SSRS
- Tableau
Certification
University of Cincinnati Healthcare Administration, 08/01/19
Accomplishments
MBA - CAPSTONE
Applying all accounting and finance concepts to achieve maximum market share from forecasting sales, marketing strategies and inventory management. Attained maximum Profit margin by managing accounts receivable, in a timely manner that lowered the cost by 13 % and contributed to the total revenues. Understanding ledgers, Accounts payable, Balance sheet and financial statements for the company. I received the highest Return on assets among other competitors. My finance courses on Market capitalization and investments helped to eliminate long term loans to build more cash on hands
Affiliations
- UC Organizations: Women in Tech Initiative
- University of Cincinnati's Graduate Student Association
Courses Completed
- Managerial Accounting
- Finance for Managers
- Health Care Economics
- Data Analytics
- Decision Modeling
- IT management
- Leadership and MGMT
- Health Information Technology
- Operation Management
- Six Sigma Lean Operations MBA - Capstone Project
- Global DNA Simulation Capstone
References
- Sierra Ciers, Financial Operations Lead, Anthem Blue Cross Blue Shield, 513 400 1378, Ciers123@yahoo.com
- Caroline McLaurin, Financial analyst, Anthem Blue Cross Blue Shield, 513 400 1378, mclaurinca@gmail.com
- Melissa Pieper, Manager Customer Service, Anthem Blue Cross Blue Shield, 920 602 1793, melissa.pieper@anthem.com
Timeline
Financial Analyst
Anthem
06.2021 - 12.2023
Grievance Analyst
Anthem
02.2021 - 05.2021
Member Service Representative II
Anthem
12.2018 - 01.2021
Medical Interpreter
Cincinnati Children's Hospital
05.2017 - 12.2018
MBA - Health Care Business Administration
University of Cincinnati, Lindner College of Business
Doctor of Medicine (MD) -
ECFMG
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