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Syed Ali Ali Raza
Male, 31 Years, Faisalabad, Pakistani
Email:-Mobile:-
Professional Summary
A result oriented professional with over 8 years of experience in Revenue Cycle Management
Operations.
Proven track record of developing procedures, service standards, operational policies,
planning and implementing effective control measures to improve the service standards.
Expertise in designing and implementing training programs for bringing keen customer focus,
high energy level and team spirit in the employees.
Excellent written, communication, inter personal, liaison and problem solving skills with the
ability to work in multi cultural environment.
Passion for leading and building a team, conducting counseling, training and development
sessions.
Strong ability to communicate ideas effectively through written and verbal material.
Skilled at learning new concepts quickly, working well under pressure, completing tasks on
time and highly effective with time management.
Ability to multi-task and work aggressive time frames with minimal supervision.
Strong decision making skills and the ability to document issues, solutions and strategies
effectively.
Extensive computer training, including knowledge of multiple networking environments and
business software.
Proficient in Windows, Excel, Word, PowerPoint, Outlook, Adobe Acrobat and most major
medical software's.
Specialties: Clinical Documentation Improvement, Coding, ICD-10, Compliance, Revenue
Cycle Management, administration, auditing, billing, charts, cms, cpt, documentation,
financial, focus, ICD-9, legal, letters, Medisoft, performance analysis, policy analysis,
programming, quality control, reports, supervisory skills, teaching, treasury, workflow
analysis.
Personal Information
Date of Birth:
Dec 4, 1985
Nationality:
Pakistani
Country:
Pakistan
Marital Status:
Single
Languages:
Punjabi (Expert), Urdu (Expert), English (Expert)
Expected Salary:
100,000 - 124,999
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Industry:
Banking/Financial Services
Career Level:
Department Head
Functional Area
Accounts, Finance & Financial Services
Address:
544-B PEOPLES COLONY#2 FAISALABAD
Work Experience
Manager Quality Assurance
MD Vision CSD LLC, Lahore, Pakistan
Apr 2016 - Present
1. Identifying faulty practices and identifying corrective actions
2. Provides second-level review of billing performances to ensure compliance with legal and
procedural policies and to ensure optimal reimbursements while adhering to regulations
prohibiting unbundling and other questionable practices.
3. Researches, analyzes, and responds to inquiries regarding compliance, inappropriate
coding, denials, and billable services.
4. Interacts with physicians and other patient care providers regarding billing and
documentation policies, procedures, and regulations; obtains clarification of conflicting,
ambiguous, or non-specific documentation.
5. Trains, instructs, and/or provides technical support to medical providers and Medical
Coding Analysts as appropriate regarding coding compliance documentation, and regulatory
provisions, and third party payer requirements.
6. Staying abreast with changing coding guidelines and government regulations
7. Reviews, develops, modifies, and/or adapts relevant client procedures, protocols, and data
management systems to coordinate these with UNM methodology, to ensure that client
billing operations meet the joint requirements of both the local facility and UPA.
8. Interacts with providers and management to review and/or implement codes and to
update charge documents.
9. Reviewed coding and billing systems and recommended proper training to employees
10. Ensures strict confidentiality of financial records.
11. Attends coding conferences, workshops, and in-house sessions to receive updated coding
information and changes in coding and/or regulations.
12. Performs miscellaneous job-related duties as assigned.
Manager Operations
Physician\'s Revenue Group, Lahore, Pakistan
Sep 2015 - Apr 2016
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1. Oversees the operations of the billing department, encompassing medical coding, charge
entry, claims submissions, payment posting, accounts receivable follow-up, and
reimbursement management.
2. Maintains contacts with other departments to obtain and analyze additional patient
information to document and process billings.
3. Prepares and analyzes accounts receivable reports, weekly and monthly financial reports,
and insurance contracts in concert with the Practice Administrator. Collects and compiles
accurate statistical reports.
4. Audits current procedures to monitor and improve efficiency of billing and collections
operations.
5. Participates in the development and implementation of operating policies and procedures.
6.Reviews and interprets operational data to assess need for procedural revisions and
enhancements; participates in the design and implementation of specific systems to enhance
revenue and operating efficiency.
7. Analyzes trends impacting charges, coding, collection, and accounts receivable and take
appropriate action to realign staff and revise policies and procedures.
8. Performs physician credentialing actions.
9. Maintains a working knowledge of all health information management issues such as
HIPAA and all health regulations.
10. Maintains library of information/tools related to documentation guidelines and coding.
11Supervises billing office personnel, which includes work allocation, training, and problem
resolution; evaluates performance and makes recommendations for personnel actions;
motivates employees to achieve peak productivity and performance.
12. Provides, oversees, and/or coordinates the provision of training for new and existing
billing staff on applicable operating policies, protocols, systems and procedures, standards,
and techniques.
13. Coordinates team member time off in a manner that does not negatively impact
necessary daily functions.
Manager Accounts receivables.
Omega Medical Billing, Faisalabad, Pakistan
Feb 2011 - Aug 2015
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Responsibilities & Results:
Improved revenue for most recent provider over 25% with same patient load
Experienced billing for Family Medicine, Ophthalmology, Dermatology, and
Mental Health specialties
Ensure claims are entered and submitted with 48 hours of receipt
Accurately apply payments to patient accounts
Post and reconcile insurance and patient payments. Research and resolve
incorrect payments, EOB
rejections, and other issues with outstanding accounts
Insure accuracy of insurance claims. Verify correct ICD-9 and CPT codes for a
variety of specialties
Set up new patient accounts
Assign ICD-9 to physicians diagnosis and insure correct level of service and
various other CPT codes
Set-up practice management software for submission of electronic claims to
clearinghouse. Work with clearinghouse to resolve file compatibility issues
Retrieve Electronic Remittance Advice (ERA\'s)
Send secondary claims upon processing of primary insurance.
Monthly processing of Patient statements. Answer and resolve patient billing
inquires
Follow up on Insurance and patient aging. Re-submit insurance claims as
necessary. Knowledgeable
in timely filing restrictions
Insure office practices are in compliance with HIPAA regulations.
Assistant Chief Manager Accounts
sadaqat textile limited., Faisalabad, Pakistan
Feb 2009 - Jan 2011
Executed accounts receivable reporting enhancements and reconciliation
procedures in order to integrate Quick
Managed accounting operations, accounting close, account reporting and
reconciliations.
Performed debit, credit and total accounts on computer spreadsheets/databases,
using specialized accounting software.
Received, recorded, and banked cash, checks, and vouchers as well as reconciled
records of bank transactions.
Reviewed previous accountants book entries to ensure accuracy of the G/L.
Reviewed collection reports with the general manager to determine the status of
collections and the amounts of outstanding balances.
Performed complex general accounting functions, including preparation of journal
entries, account analysis and balance sheet reconciliations.
Skills & Expertise
Bookkeeping
1 Year
Capital Budgeting
5+ Years
Channel Sales
2 Years
CIA
