Summary

Adnan Waheed
Professional Profile


Experienced for more than 16 years as Medical Billing Denial Management Revenue Cycle Management Specialist. In-depth knowledge of medical terminology, medical billing processes with experience on multiple systems.


Exceptionally good at dealing with the queries and complaints of the customer and identifying the solution.


PPACA & ERISA Judicial Proceedings Specialist.


An accomplished Healthcare Management Professional with extensive experience in managing leading Healthcare clients in U.S. and U.K.


Very energetic, hardworking, and self-motivated.


Excellent in communication both verbally and written with organizational and interpersonal skills. interpersonal skills.


Head of Operations -Medical Billing Revenue Cycle Services. Business Development in Health Care Information Technology, HIPAA, Health Care Management. Health Informatics Professional Certified Medical Billing Coding –Revenue Cycle Consultant Certified HIPAA Professional Centralized Accounts Payable Specialist PPACA & ERISA Judicial Proceedings Specialist. Program Management, PMO, Healthcare Management.

Projects

HIPAA COMPLIANCE AUDIT 01

Experience

Company Logo
Country Head-HealthCare Operations
A&A Management Consulting Services
Oct 2019 - Present | Karachi, Pakistan

Management of the Billing and Collection Department including revenue cycle management, social media, business development, and overall staff supervision.
Responsible for employee interviews, hiring, developing job descriptions, employee evaluations, disciplinary actions, and terminations. 
This includes timely processing and completion of all paperwork in regards to the above-identified areas.
Administer, direct and coordinate all work activities, evaluating effectiveness as necessary
Interact with Insurance Carriers as needed.
Conduct performance review of all personnel on the team.
Oversee and resolve all medical claims, insurance verification, and eligibility. Patient responsibility, payment posting, EOBs, appeals, denials, reimbursements, co-pays, deductibles, and adjustments.
Manage the implementation of HIPAA Certification
Develop new and effective business plans to maximize productivity and ensure quality.
Review and audit reports for assigned functional areas at least once a month to ensure that timely processing is occurring, comparing reports to industry standards, and identifying and researching discrepancies.
Monitor and assist department staff in determining the cause of delays in reimbursement and perform necessary functions to receive payment in a timely manner.
Prepare and give staff direction and conduct staff meetings as needed for purposes of maximizing effective communication in the area of projects, financials, overall results, etc.
Develop strategic plans and goals for utilizing social media in the promotion of the Organization’s objectives.
Prepare and give presentations and/or provide training for educational purposes as requested.
Identify and report unusual trends or patterns to the central office and assist in problem-solving by providing necessary documentation and recommendation for resolution

Company Logo
Head of Department Medical Billing Revenue Cycle
Physicians EMR, LLC
Jun 2018 - Sep 2019 | Lahore, Pakistan

• Managing the Medical Billing and Collections Team of over 30 employees.
• Responsible for management of the Billing & Collection department includes revenue cycle management, staff supervision, registration, credentialing, and collections.
• Having experience with development team of EMR/EHR software knowledge, medical group billing including surgical, data reporting and analysis or related experience
• Monitoring, track and address staff workflow, production and quality issues.
• Develop and provide performance metrics to management and to the team.
• Hire new staff and train employees on processes and best practices.
• Identify trends and implement action plans to maximize revenue.
• Generate month end reports using advanced Excel functions for management reporting.
• Interact with Insurance Carriers as needed.
• Conduct performance reviews of all personnel on the team.
• Develop new and effective business processes to maximize productivity and ensure quality.
• Develop tracking and analysis for medical claims from billing through final resolution.
• Understand, oversee and resolve all medical claims, insurance verification and eligibility, patient responsibility, short pays, payment posting, EOBs, appeals, denials, reimbursements, co-pays, deductibles, appeals, and adjustments.
• Managing all aspects of their complex and dynamic billing department, both for their diagnostic business and their DME business

EMR- EHR -PMS & MACRA/MIPS Consulting & Coordinating
• Assisting in EHR and EMR PMS Integration process
• Implemented & give training on EMR and related technology in doctors' offices & Hospitals
• Consulted doctors on EMR selection and Operation Services
• Advised and provided suggestion for Initial-Draft Infiniti Physicians EMR (iPEMR) Training Manual

Company Logo
Healthcare Management SME – (Medical Billing Revenue Cycle)
Arthur Lawrence (Pvt.) Limited
Jan 2010 - May 2018 | Karachi, Pakistan

Education

University of Karachi
Masters, , Masters in Business Administration‎
Human Resource Management
CGPA 3.1/4
2009

Skills

Expert Accuracy and Attention to Detail.
Expert Communications Skills.
Expert Proficiency in spoken and written English
Expert Strong verbal
Expert Written and Verbal Communication.
Expert Creativity/Innovation
Expert academic writing
Expert accounts and finance
Expert Budgets
Expert Business Networking
Expert Business Strategy
Expert communication
Expert control
Expert coordination and presentation
Expert CRM
Expert Customer Service Certification (CBP)
Expert data
Expert data monitoring
Expert decision making
Expert Delegation
Expert Distribution Network
Expert education research experience
Expert Enterprise Product Development
Expert Exp in B2B online marketing
Expert Freight
Intermediate FREIGHT FORWARDING
Intermediate freight transportation
Expert Good Communication
Expert Handling Portfolio of VAS
Expert hardworking
Expert Human Resources
Expert ICD-10
Expert International Logistics
Expert IT
Expert learning and development
Expert locations
Expert managing team
Expert MARKETING EVENT PLANNING
Expert Marketing Management
Expert medical coding
Expert medical transcription
Expert monitoring & evaluating programmes
Expert Narrative Developing
Expert Negotiation and mediation
Expert organizational plann
Expert other qualifications as noted in SOW
Expert Positive Attitude
Expert Profit & Loss
Expert Project Administration
Expert Project Management

Languages

Expert Urdu
Expert English

Adnan Contacts

BILAL AKHTAR
iSolutions Pakistan (Pvt) Ltd