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Aftab Islam

Provider Credentialing and Contracting Specialist

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About
I have more than 5 years working experience in a healthcare industry. I've experienced in Sales/ Telemarketer, Business Development, Credentialing Licensing and Contracting, and Project Management.  Experienced in Group/Individual Medical and Ancillary Provider enrollment into different insurances (Medical, Medicare, Commercial Carries and IPAs). I've always been detailed Oriented in my work. I am a hard worker, with high-level of commitment, organized and responsible. I can work independently as well as collaboratively and work well under pressure.  I am a team player and at the same time I can work individually with minimum supervision. I always make sure that output is quality and I know I am contributing to the team and business.
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Experience
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IPS BPO
Jun 2020 – Present
Lahore
Credentialing Specialist
• Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications • Maintain internal provider grid to ensure all information is accurate and logins are available • Update each provider’s CAQH database file timely according to the schedule published by CMS • Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance • Complete revalidation requests issued by government payers • Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid • Complete re-credentialing applications for commercial payers • Credential new providers and re-credential current providers with hospitals at which they hold staff privileges • Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing • Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases • Other duties as assigned
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F&A Global
Jan 2019 – Apr 2020
Lahore
Credentialing Specialist
• Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications • Maintain internal provider grid to ensure all information is accurate and logins are available • Update each provider’s CAQH database file timely according to the schedule published by CMS • Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance • Complete revalidation requests issued by government payers • Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid • Complete re-credentialing applications for commercial payers • Credential new providers and re-credential current providers with hospitals at which they hold staff privileges • Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing • Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases • Other duties as assigned
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Transcure llc
Sep 2017 – Dec 2018
Lahore
Patient Support Specialist
• Establishes close relationships with patients, building rapport and trust with patients in an empathetic manner. • Assist patients in referrals, scheduling, accessing, and utilizing services with their primary care provider (PCP). If the patient does not have a PCP, support establishing a PCP. • Maintain accurate and timely documentation of all patient encounters and complete reporting requirements according to organization standards. • Track patient information, schedules, files, and forms in a confidential manner. • Communicate with the Care Team (Care Coordinators, providers and care center staff) to discuss • patient care issues and needs and how best to facilitate care services. • Track patient attendance at medical appointments and initiate outreach on any missed • appointments, providing education on the value of keeping appointments, as necessary. • Outreach to patients after primary care appointments to review and update care plan, schedule future appointments and referrals. • Screen patients for Social Determinant of Health (SDOH) and, as needed, connect patients with community resources such as transportation, housing, mental health, etc. • Able to identify symptoms of distress and act/intervene appropriately. • Maintain strict confidentiality in accordance with department and organizational policies. • Other duties as assigned.
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Semalt
Jan 2014 – Dec 2016
Lahore
Customer Success Manager
• Create a Governance and Executive relationship with customer’s key stakeholders • Understand our customers' business needs, use cases and priorities. • Define and maintain customer’s success criteria and planning in terms of deployment, adoption, operations and business outcomes. • Build knowledge of customer’s environment, become the customer’s champion at Transmit Security • Review customer’s evolving needs with the Product Management team. • Present product roadmap and confirm alignment with the customer's agenda. • Ensure smooth on-boarding and help maximizing product value. • Act as a "trusted" adviser to the customer to strengthen customer relationships. • Engage with Professional Services Consultants on specific project-based activities • Keep track of customer health score, communicate and escalate risks Work with Sales and Field Engineers to develop new opportunities. • Be accountable for the solution provided to the customer to ensure great service, customer satisfaction and success.
Education
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Lahore Leads University
Oct 2018 – Oct 2020
MSc, International Relations and Affairs