This resume is a sample for the post of Medical Claims Coordinator. A medical claim coordinator is a person who supervises and manages all the approved accidental and casual cases of the clients. The medical claim requires case solutions on an urgent basis. A Coordinator sees to it. He makes sure that all the cases are carried on smoothly and to the satisfaction of the customer. The insurance company is more interested in hiring a resourceful person with references and contacts for his claims with additional knowledge of medical field and great judgment skill. A person who has the quality, experience, and capability of solving all cases to customer’s satisfaction Resume is your first interface with the employer. The resume sample given below should guide you in building an impressive resume. Finally adding references to your resume will stand your resume out among others.
How A Good Resume Should Be Written?
The resume is your first interface with the recruiter. It is your very introduction, invest good time in making an effective and persuasive resume. The resume sample given below is created by the experts keeping all the crucial points of the employer in mind. There are some basic tactics to make your resume stand out from another pile of resumes; firstly make it as reader-friendly as possible. Use the right font size and style to make the reader read without much effort. The quality of your paper, sheet and folders DOES matter so don’t skimp on it. The details about your qualifications and experience should be precise but not too lengthy to force the reader to glide through or not too short to give him an impression of a scanty or neglected resume. Your picture should be updated and clear. And lastly references to their addresses and immediate contact numbers would seal your success in getting the job.
Our Medical Claims Coordinator Resume Sample is perfect.
The information, although, is fake and is mostly put there to give you ideas about presenting yourself. Frequent use of bullets is practiced as it gives the reader a precise idea about your point of view without really stressing it. Text formatting is avoided to prevent the content from over-emphasis. The text is created in MS Word and can be easily modified and edited there. See also
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Medical Claims Coordinator Resume Sample
Name: XYZ
International city, Dubai
Cell No. 0000
Professional Profile
Aim to secure a responsible position in the field of Insurance where able to utilize my knowledge and technical skills by maintaining a positive environment in the working place.
Professional Experience
Medical Claims Coordinator:
- Managing all Reimbursement/Direct Billing claims for NLGI.
- Managing Approvals received from TPA and Hospitals.
- Replying to queries from TPA/Broker and Client Via Phone calls (Approx. 35 calls per day/includes calls during office hours and out of office)
- Replying to queries from TPA/Broker and Client Via Email (Approx. 75 – 100 emails per day).
- Maintaining claims tracker for Reimbursement claims/ Direct Billing approvals/ and medical death claims.
- Evaluating and Issuing approvals to the TPA for all direct billing approvals above 20,000 AED(Approx. 50- 60 approvals per month).
- Attending meetings held by Broker/Client and TPA.
- Visit the hospital for high-cost claims.
- Assist Cheque dispatch.
- Coordinating with HO for approvals and all other issues via email and Phone.
- Coordinating and Arranging for Direct billing with TPA(Paramount Health Services)
- Extracting Utilization report and beneficiary list as and when requested by Sales/Operations.
- TPA payments and float fund management.
Duty Medical Officer
- Provides medical patient care by interviewing, examining and treating clinical patients in order to meet their medical needs.
- Educates patients on wellness, prevention and early detection by providing materials and resources to the patients and families, Diet and regimen advice.
- Determines which referrals are required based on examination and patient needs.
- Insurance Claim form filling and processes.
- Determines which referrals are required based on examination and patient needs.
- Exercises final medical judgment in all issues of health care.
- Prescribes medical treatment patients.
- Documents all services in patient medical record Reviews on a regular basis long term cases that require ongoing medical attention.
- Consults with Medical Director and other professionals on staff as needed regarding patient care, assessment, and education issues.
- Participates in quality improvement, management, continuing education, and other patient care programs established by the hospital or clinic requirements.
- Assists in the resolution of complaints, requests and inquiries from patients.
- Maintains confidentiality of all patient information according to federal guidelines and regulations.
Medical Registration
Medical Council
Homoeo Medical Registration Certificate-A
Registration Number: 000
Homeopathic medical council
Homoeo medical Registration Certificate-A
Registration Number: 000
Professional Education | Certifications
- RVS HOMOEOPATHIC COLLEGE & HOSPITAL.
- BHMS (Bachelor of Homoeopathic medical science and Surgery)
- ICRM (Institute of Clinical research management).
Certificate in Clinical research management.
Internship/ Training
- Training for Basics of infertility treatment, Infertility counseling, Pelvic scan, IUI and IVF laboratory techniques.
- Industry internship at Clinical trial site from IQRAA international hospital ,Calicut, Kerala
- Compulsory rotatory residential internship program from RVS Homoeopathic Medical College & Hospital. Certifications Presentation/Thesis
Dissertation submitted to the Tamilnadu Dr.MGR Medical University, Chennai as “A CLINICAL STUDY ON IRRITABLE BOWEL SYNDROME (IBS) AND ITS HOMOEOPATHIC MANAGEMENT” as partial fulfillment of the rules and regulation for the degree of Bachelor of Homoeopathic Medicine and Surgery (BHMS) under the guidance of Dr. Vinay Kumar MD (HOM), Head of the department of Forensic Medicine and Toxicology, RVS HMC, Coimbatore, Tamilnadu.
Seminar/Conferences
- Attended one day workshop on “SOURCE DOCUMENTATION” by Harish V Shankarankutty, Senior Clinical research associate & quality reviewer, GSK Pharmaceutical Ltd held at Institute of Clinical research Management, Calicut on 26th of August 2010
- Attended one day workshop on “QUALITY MANAGEMENT IN CLINICAL TRIALS” by Harish V Shankarankutty, Senior Clinical research associate & quality reviewer, GSK Pharmaceutical Ltd held at Institute of Clinical research Management, Calicut on 23RD of September 2010.
- Attended the seminar on Food weapon conducted by IHMA (Indian Homoeopathic Medical Association).
- Attended the continuing medical education program (CME) on Arthritis and its management conducted by IHMA (Indian Homoeopathic Medical Association).
- Kerala state conference 2011 ‘FORSCHENE’ by IHMA (Indian Homoeopathic medical association) facilitated by Dr.Jayesh Bellare (Phd FNASc FNAE), IIT, Bombay (Scientific evidence for the presence of medicines in higher potencies).
Personal Profile
AGE & DATE OF BIRTH : 00
SEX : Female
MARITAL STATUS : Single
PASSPORT No : 00000
VISA STATUS : 0000
NATIONALITY : Indian