Cpc Dr Sheethal Es Bhms

Senior Officer - Medical Audit, Medical Risk Evaluation And Reimbursement Claims Management at Union Insurance

Dr Sheethal ES BHMS, CPC has a diverse range of work experience in the medical field. Dr Sheethal ES started their career as a Doctoral Intern at DPMHMC, where they gained experience in taking observations and prescribing medications for inpatients and outpatients. Dr Sheethal ES then worked as a Junior Consultant Physician at a Homoeopathic Clinic in India, where they provided care to patients, created treatment plans, and diagnosed diseases. Following this, Dr Sheethal worked as a self-employed Doctor at their own practice before joining InayahTPA as a Medical Approval Officer. In this role, they handled prior approvals for outpatient and inpatient services and had knowledge of reimbursement claims. Dr Sheethal ES also had expertise in coding systems and was familiar with DHA, HAAD, and OMAN exclusions. Dr Sheethal then transitioned to Howden Turkey, the Middle East, and Africa, where they served as a Medical Claims Processor. Their responsibilities included reviewing claim submissions, processing claims, and preparing related documents. Currently, Dr Sheethal works at Union Insurance as a Senior Officer in Medical Audit, Recovery & Medical underwriting. In this role, they execute strategies to sample, analyze, and audit medical claims to reduce fraud and abuse. Dr Sheethal ES also ensures compliance with policies, guidelines, and regulatory bodies while maintaining smooth operations.

Dr Sheethal ES obtained their Bachelor's degree in BHMS from KUHS, where they studied from 2011 to 2017. Dr Sheethal ES also obtained a certification as a Certified Professional Coder (CPC) from the AAPC, although the specific month and year of obtaining this certification are not provided.

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Timeline

  • Senior Officer - Medical Audit, Medical Risk Evaluation And Reimbursement Claims Management

    February, 2023 - present