Summary
Overview
Work History
Education
Skills
Certification
Achievements And Highlights
Timeline
Generic

Abdul Sami MOHAMMED

AUBURN,New South Wales

Summary

Healthcare professional with extensive experience at PrimEra Medical Technologies, specializing in denial management and revenue cycle optimization. Achievements include significant reduction in denials and improved compliance and operational efficiency. Expertise in US healthcare insurance and team performance management drives process improvements and strengthens client relationships.

Overview

8
8
years of professional experience
1
1
Certification

Work History

Reviewer – Operations (Denial Management)

PrimEra Medical Technologies Pvt. Ltd.
11.2015 - 10.2018
  • Led denial management operations for 45+ hospital facilities, reducing denials and increasing revenue through effective inpatient and outpatient appeals.
  • Handled transitions of new business processes: planning, hiring, training, and monitoring team performance.
  • Created dashboards, monitored KPIs, and ensured SLA adherence and compliance.
  • Conducted training programs and mentoring for team development.
  • Acted as single point of contact (SPOC) for documentation, reporting, and audits.
  • Worked closely with U.S. clients and senior leadership on process improvements and new business opportunities.

Telemedicine Consultant

e-MediCard
Hyderabad
07.2014 - 10.2015
  • Provided teleconsultation and home visits for patients.
  • Reviewed patient vitals and EMRs, provided first-line treatment and follow-up advice.
  • Recruited and managed doctors, scheduled meetings, and improved team performance.

Resident Doctor / Medical Officer (Clinical Work)

01.2011 - 01.2014
  • Worked in emergency care, ICU, cardiology, cosmetic surgery, and general medicine departments.
  • Responsibilities included: history taking, clinical assessments, drug monitoring, discharge summaries, and assisting procedures like C-sections and surgeries.
  • Key hospitals: Yashoda Hospital Malakpet, Apollo Hospital Jubilee Hills – Cosmetic Surgery Assistant, Asian Institute of Gastroenterology – ICU & Emergency, Max Cure Hospital Secretariat – Cardiologist Assistant, Challa Hospitals – Emergency Physician.

Education

Advanced Diploma - Leadership and Management

Australasian International Academy
Sydney, Australia
01.2022

Diploma - Leadership and Management

Australasian International Academy
Sydney, Australia
01.2021

MBBS -

Zhengzhou University
Henan Province, China
01.2011

Internship -

First Affiliated Hospital of Zhengzhou University
01.2011

Skills

  • US Healthcare Insurance (Provider Side)
  • Denial Management & Appeals (CMS, Milliman, InterQual)
  • Revenue Cycle Management (RCM)
  • EMR/EHR Tools (EPIC, Meditech, Cerner, CPSI, Paragon)
  • HIPAA Compliance & Quality Standards
  • Clinical Documentation & ICD-10 Coding
  • Team Training & Performance Management
  • Leadership & Business Transition
  • Strong Communication & Analytical Skills

Certification

  • GCH
  • Basic Life Support (BLS)
  • Advanced Cardiovascular Life Support (ACLS)
  • Airway Management
  • Emergency Rescue & Fire Safety Training
  • People & Man-Management Development Program

Achievements And Highlights

  • Zero Attrition Project through people engagement initiatives
  • Trained and mentored new hires in denial management and RCM
  • Recognized by R&R Committee for performance and client satisfaction
  • Improved quality metrics to 100% through continuous learning and updates
  • Frequent interaction with U.S. clients for audits, training, and workflow improvement

Timeline

Reviewer – Operations (Denial Management)

PrimEra Medical Technologies Pvt. Ltd.
11.2015 - 10.2018

Telemedicine Consultant

e-MediCard
07.2014 - 10.2015

Resident Doctor / Medical Officer (Clinical Work)

01.2011 - 01.2014

Advanced Diploma - Leadership and Management

Australasian International Academy

Diploma - Leadership and Management

Australasian International Academy

MBBS -

Zhengzhou University

Internship -

First Affiliated Hospital of Zhengzhou University

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