Aileen Albert Simpson
Tamworth,NSW
Summary
Dynamic healthcare professional with extensive experience in hospital set up, excelling in claims processing, medical coding and denial management. Proven ability to enhance billing compliance and documentation accuracy while delivering exceptional customer service. Adapt at collaborating with interdisciplinary teams to optimize patient care and streamline operations.
Overview
16
16
years of professional experience
Work History
ASSISTANT CLAIMS OFFICER
Al Ain Hospital (Abu Dhabi Health Services SEHA)
Al Ain, Abu Dhabi, United Arab Emirates
05.2011 - 11.2023
- Streamline coding and billing processes for medical consumables and medical devices across departments.
- Manage Inpatient and Outpatient claims with compliance to Insurance adjudication rules and standards.
- Execute denial management strategies to minimize claim rejections and maximize reimbursements.
- Ensure swift, accurate submission of clean claims within required deadlines.
- Coordinate with departments to maintain comprehensive patient documentation.
- Frequent and timely monitoring of unbilled claims rigorously, tracking updates and follow-ups.
- Collaborate with involved teams to efficiently handle high volumes of claims.
- Maintain organized documentation for claims, ensuring accuracy in coding.
STAFF NURSE
Apollo Hospitals
Chennai, Tamil Nadu, India
04.2008 - 08.2010
- Assess and monitor patient vitals pre- and post-surgery, adjusting treatment plans as necessary.
- Coordinate patient care with clinical staff to implement interventions and ensure continuity.
- Provide wound treatment using liquid skin, sutures, and bandages while adhering to safety protocols.
- Transport patients to rooms, respective departments preparing them for treatments based on individual needs.
- Administer oral, IV and intra-muscular medications and monitor patient reactions.
- Deliver emotional support and counseling to patients and families during recovery process
- Maintain and adhere to strict safety protocol measures and policies
- Ensure confidentiality of sensitive patient information as per health department rules and regulations.
- Participate in quality improvement initiatives targeting infection control and discharge planning.
NURSE ASSOCIATE
Apollo Hospitals
Chennai, Tamil Nadu, India
10.2007 - 04.2008
- Assisted nurses with daily patient care, including dressing wounds and providing hygiene assistance.
- Reported any changes in patient condition immediately to the RN or physician on duty.
- Provided emotional support for family members during difficult times in the hospital setting.
- Assisted with administering medications under the direction of a Registered Nurse.
- Ensured that medical equipment was properly maintained and functioning correctly.
- Recorded observations on patient charts regarding activities of daily living, intake and output levels, vital signs.
- Changed bed linens, cleaned patient rooms and assisted with transfers of patients in wheelchairs or beds as needed.
- Observed universal precautions at all times when handling infectious materials or bodily fluids.
- Participated in team meetings with other healthcare professionals about individual patient plans of care.
- Assisted with admission, discharge and transfer procedures of patients according to hospital policy and procedure guidelines.
- Delivered high level of care to every patient.
- Turned and repositioned residents using proper body mechanics to prevent pressure ulcers.
- Facilitated activities of daily living, personal hygiene management, feeding and ambulation.
Education
CCS (Certified Coding Specialist) - Health Information Management
AHIMA (American Health Information Management Asso
America11-2019
Bachelor of Science - Nursing
Vel R.S College of Nursing
Chennai, Tamil Nadu, India08-2007
HIGH SCHOOL - HIGH SCHOOL
L F GIRLS HIGHER SECONDARY SCHOOL
NAGERCOIL, TAMIL NADU, INDIA03-2003
Secondary School - School
Indian School Alain
Alain, Abu Dhabi, UAE06-2000
Skills
- Claims processing and denial management
- Medical coding and billing compliance
- Documentation review
- Effective communication and problem solving
- Data entry
- Task prioritization
- Adaptability and flexibility
- Customer service
- Team collaboration
- Records management
- Computer proficiency
- Time management
- Medical terminology
- Quality assurance
- Professionalism and ethics
Affiliations
- I enjoy music, singing and watching documentaries. I also like to bake and cook and explore different cuisines from around the world.
Languages
English
Professional
French
Limited
Tamil
Native/ Bilingual
Hindi
Limited
References
References available upon request.
Timeline
ASSISTANT CLAIMS OFFICER
Al Ain Hospital (Abu Dhabi Health Services SEHA)
05.2011 - 11.2023
STAFF NURSE
Apollo Hospitals
04.2008 - 08.2010
NURSE ASSOCIATE
Apollo Hospitals
10.2007 - 04.2008
CCS (Certified Coding Specialist) - Health Information Management
AHIMA (American Health Information Management Asso
Bachelor of Science - Nursing
Vel R.S College of Nursing
HIGH SCHOOL - HIGH SCHOOL
L F GIRLS HIGHER SECONDARY SCHOOL
Secondary School - School
Indian School Alain
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