Ashraf

1. Creating medico legally compliant, clinically sound high quality outpatient visit documentation for some of the best US Hospitals across multiple specialties.

2. Listening and comprehending recorded patient physician

interactions, developing an impression about the clinical condition and documenting clinical history, examination findings & plan of action.

3. Creating highly structured (literally medical text-book style) clinical notes, summarizing findings and insights with sections such as history of present illness, review of systems, physical examination, assessment details, treatment plan etc.

4. Populating the summarized data in the electronic health record.(EHR)

5. Maintaining clinical note quality using documentation norms and physician preferences.

6. Understanding and maintaining desired level of clinical knowledge based on assigned specialty 7. Reviewing edits made by the provider before approving the clinical note and working collaboratively with training and quality to improve the provider experience

8. Sharing best practices and help create a knowledge repository to capture tacit knowledge

Analyzing errors and transferring the clinical documents into the EPIC EHR.
Training multiple juniors on the process.
Accurately and efficiently documenting patient medical histories, physical examinations, procedures, treatments, and other clinical encounters in the EHR system.
Collaborating with healthcare providers during patient visits to capture information in real-time, ensuring timely and accurate record keeping.
Utilizing a strong understanding of medical terminology, abbreviations, and procedures to accurately document clinical information.
Reviewing and editing documentation to ensure completeness, clarity, and adherence to established guidelines and protocols.
Assisting with assigning appropriate medical codes for diagnoses, procedures, and treatments to support accurate billing and claims processing.

Canceling or upgrading accounts.
Assisting with placement of orders, refunds, or exchanges.
Advising on company information.
Taking payment information and other pertinent information such as addresses and phone numbers.
Placing or canceling orders.
Answering queries about warranties or terms of sale.

Assessment of claims based on guidelines and procedures set by the company.
Adjudication of claims to achieve quality and production standards applicable for this position.
Claim processing in accordance with benefit schedules and provider contracts.
Ensuring quality control on output and customer interaction points.
Analysis based on various parameters and benchmark against industry/new standards.

Worked in HGS which involves health insurance for clients based out of US.
Initially joined as ACPE (Assistant Claim Processing Executive) and then promoted to CPE (Claim Processing Executive).
Worked in different process which explains about RCM (Revenue Cycle Management).
Trained on hospital claims.