Mirza Abbas Hussain

Experienced Health claims professional with 5 years of experience in health claims processing, auditing and reviews.

A skilled Health Insurance professional with 5 years of experience in the industry, seeking a challenging role in a reputable company to apply my knowledge and expertise to help clients navigate the complex world of health Insurance.

 Strong knowledge of various health insurance products,

plans, and regulations.

 Excellent communication and interpersonal skills to effectively interact with clients, colleagues, and providers.

 Ability to analyze and interpret medical claims, billing,

and other related data.

 Proficient in using various software and tools related to health insurance.

 Detail-oriented, organized, and capable of multi-tasking to ensure timely delivery of tasks.

 Ability to work independently and as part of a team to achieve common goals.

 Audited and processed medical claims and billing for accuracy and compliance with industry standards and regulations.

 Investigated and resolved claims denials, appeals, and complex billing issues.

 Reviewed medical records and identified improper coding, billing, and other discrepancies.

 Communicated with healthcare providers to obtain additional information or clarification regarding claims.

 Maintained accurate records and documentation of claim processing and auditing activities.

 Participated in quality assurance activities to ensure compliance with established standards and procedures.

 Trained and mentored new claims processing and auditing staff.

• MBBS Medical doctor graduated from Tbilisi State Medical university