CURRICULUM VITAE :
SHAIK MOHAMMAD HUSSAIN
e-mail : sk_mohd1984 AT yahoo.com

CAREER OBJECTIVE :
To be a part of an esteemed organization and be responsible in its successful functioning while working as a part of the team that excels in handling all types of corporate challenges efficiently thereby ensuring impeccable results for the organization while improving.

CAPABILITIES :
High aims enough confident to complete my work quickest as possible, good communication skills.

EDUCATION QUALIFICATION :
Level Board Percentage :
S.S.C Board of Secondary education 63%
Intermediate Board of Intermediate 60%
Degree (Bsc. Computers) Osmania University, Hyd. 61%

CURRENT JOB EXPERIENCE :
Organization : UnitedHealth Group Information Services
Designation : Claims Associate
Process Name : UCSI- United healthcare Clinical Services Intake
- I have been working in UHGIS as a Claims Associate Since 16th August 2010 to till date.
- Basically dealing with Outpatient/Inpatient Prior Authorizations.
- Generating Prior authorization for member, verification and corrections of Diagnosis and procedure codes.
- Process deals with outpatient prior auth, it includes verification of member’s plan (SH and CO) Eligibility and coverage’s included for the member and approving accordingly.
- It involves Entry, Quality Checking and Random Checking
- Provider/facility update, verification and corrections
- We follow the process flow chat and updates as per the client requirement.
- We process all procedure types like(Home health, DME, Therapies, Medical, Surgical…etc)

Roles and Responsibility :
- Doing quality audits and work assigning to the team.
- Maintaining all reports(EOD,Daily count sheet,Snapshots) behalf of temp SME
- Sharing process updates and Clarifying doubts to the entire team.

Achievements :
1.Awarded as for the Best Performer i.e., “Star of the Month” in April, May 2011 and Jan 2012.
2. Awarded two times “Rising Star of the Month”.

Job Experience 2 :
Organization : DST Worldwide Services India Pvt Ltd
Designation : Executive
Process Name : AIM ( Automated Image Management)
Duration : Since 3rd Jan 2008 to 22nd July 2010.
Place : Greenlands, Begumpet.

JOB PROFILE :
1 Making Transactions of Health Care Insurance Claims.
2 Claims Vertexing : It is a Process of Verifying and Capturing the data from HCFA ( Health Care Financial Administration) 1450 & 1500 Form types.
3 We Process all form types like OCR (Optical Character Recognition), Manual, Multy, 1450 forms and FSG.
4 We Follow the Guidelines According to Process Requirement.
5 We Process all the form types like
6 KHPE ( Keystone Health plan East)
7 PPO ( Preferred Provider Organizer)
8 PPA ( Passport Advantage)
9 KC-65 (Key Care 65)
10 AH ( Ameri Health)
11 FSG ( Fairmont Speciality Group )

JOB EXPERIENCE 3 :
Organization : E-seva Department of IT& C (Govt of A.P )
Designation : Customer Care Executive.
Duration : Since August 2005 to 2nd Jan 2008.
Place : Banjarahills, Road no 7, Hyd.

JOB PROFILE :
1 Providing On-line Information to Consumers.
2 Making Transactions of Govt and Private Organizations.
3 Collection of all bills through different Paymodes like Cash, Cheque, Credit card, debit card to the Consumers.

TECHNICAL :
D.C.A ( Diploma in Computer Application ) From “ESKAYS PCCS” Computer Education Institute, Babu Khan Estate, Basheer Bagh, Hyd.

TYPING : Alpha 40Wpm and Numeric 80Wpm With 100% Accuracy.

SOFTWARE PROFICIENCY :
1 Operating System : MS-DOS, Windows.
2 Languages : C, C++
3 Packages : MS-OFFICE, DBMS,Web Technologies.

Personal Strength :
1 Good Communication Skills.
2 Can easily adapt to work environment.
3 Hardworking, Positive attitude.
4 Ability to work under Pressure.
5 Zeal to learn New Things.

HOBBIES :
1 Watching and Playing Cricket.
2 Listening slow Music.

Personal Profile :
Date of Birth : 11-11-198.
Marital Status [/b]: Married
Gender : Male
Nationality : Indian
Languages Knows : English, Hindi, Telugu

Declaration :
I hereby declare that the above mentioned information is correct up to my knowledge and I bear the responsibility for the correctness of the above mentioned particulars.

Date :
Place :

(Shaik Mohammad Hussain)