mohammed Alraey

Responsible for timely and accurate billing claim submission to responsible third-party payers. Responsible for monitoring and development of Business Office billing staff. Assures compliance with Medicare, Medical, Commercial Insurances, Federal and State Laws impacting health care. Monitors and creates edits in the electronic billing system to achieve accurate high clean claim ratios. Coordinates office efforts and works closely with Recovery Supervisor to expedite collections.

Oversees the billing functions, including the initiation of goals and procedures, overseeing daily

• operations, and coordinating office efforts to expedite payment of accounts.
• Supervises hourly employees in the performance of tasks associated with billing and collection from
• third-party payers. Monitors billing processes of billing staff to assure that billing is correct and
• timely.
• Reviews and resolves issues related to claim generations, clean claim ratios, rejected, denied
• billings. Determines the accuracy of charge capture, missing charges, late charges, covered and
• non-covered charges.
• Ensures that all required information is attached to every billing form, TAR.
• Ensures appropriate and professional communication with payers and patients.
• Elevates issues with payers and reports improvement as appropriate.
• Serves as a resource to staff by answering questions, assisting with problems, and providing
• training as necessary.
• Implements quality and performance improvement measures for the business office.
• Participates in the development of unit policies and procedures
• Ensures timely submission and acceptance of claims to all payers.
• Must be capable of performing all tasks required of hourly billing and collection employees.
• Uses a wide variety of communication formats to keep staff regularly informed and trained with
• one-to-one and team meetings.
• identifies accounts not selected for billing (ANSB). Reviews system-generated billing,
• collections, and medical records abstracting reports to monitor weekly collections billed and
• unbilled accounts.
• Communicates issues that are preventing timely and accurate billings to appropriate hospital
• department Manager for the performance improvement process.
• Identifies and collects on underpaid accounts.
• Reviews Claim Edit List to monitor specific issues, as well as recurring issues and resolution.
• Recommends future course of action based on data interpretation and recommends system
• changes, as appropriate.

BSc   Faculty of Commerce