Mohd Sadaan

Experience

• 

  Pacific Global Inc.

  Sept 2022 - Oct 2023

  Accounts Receivable Executive

  •Responsible for looking after denied medical claims and reopening them to receive maximum reimbursement from the insurance companies.•Responsible for calling/searching through Web portals of Insurance companies (in US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable.•To prioritize the pending claims of High Dollar from the aging basket and convince the claims company(payors) for payment of their outstanding claims.•To check the appropriateness of the insurance information given by the patient if it is inadequate or unclear.•To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance. •Escalate difficult collection situations to management in a timely manner.•Review provider claims that have not been paid by insurance companies.•Post cash and write off the contractual adjustments accordingly while working on the accounts. Show less

• 

  Optum

  Oct 2023 - now

  Collections Representative

  • Accurate processing and Completion of Physician/Pharmacy Claims. • Process claim that route out of automatic adjudication, within current turn around standards. • Also responsible for verifying authorization and its Validity, Necessity and the units approved for drugs billed for the DOS. • Be able to analyze EOB and denials at a claim level in #'s, leading to process improvementsAnalyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR.• Contacting payers via Calls, Chat and emails to get the Status of the claim submitted. Show less