Ali Shafique Khan

• Directed and supervised hospital utilization practices, ensuring optimal resource allocation and operational efficiency.
• Managed and enforced medical coding standards and clinical administration protocols to maintain accuracy and compliance with industry regulations.
• Oversaw the regulatory framework for hospital licensing, including the Punjab Health Commission (PHC) and other essential accreditation bodies.
• Ensured adherence to all licensing requirements and facilitated the acquisition and renewal of necessary hospital licenses.
• Coordinated with regulatory agencies to address and resolve compliance issues, contributing to the hospital’s overall operational integrity.
• Oversaw and managed medical procedures in the cath lab and various surgical units, ensuring compliance with clinical protocols and optimizing patient care.
• Developed and implemented hospital policies and medical pathways, aligning them with core values and international standards for enhanced patient outcomes.
• Created and enforced policies, rules, and regulations for surgical departments, ensuring adherence to best practices and regulatory requirements.
• Designed and maintained procedural guidelines to streamline operations and improve the efficiency of surgical interventions.
• Collaborated with clinical teams to ensure that all procedures and practices met established standards and improved patient safety and care quality.
• Self-motivated, with a strong sense of personal responsibility.
• Assisted with day-to-day operations, working efficiently and productively with all team members.

• Performed detailed audits of medical records to ensure completeness and accuracy of coding
• Developed a series of coding challenges to assess staff progress and identify areas of improvement
• Developed and maintained a comprehensive library of medical codes and descriptions, ensuring compliance with coding standards
• Implemented a system for inventory management and tracking of IT assets, resulting in improved asset management and cost savings
• Implemented an automated asset management system that reduced manual tasks by X%, allowing for more efficient resource utilization.

• Manage and lead clinical expansion activities within the hospital including all MSA projects hospital wide
• Manage day-to-day Medical Staff Affairs (MSA) operations as per standardized Quality Assurance, and supervise/manage relevant staff
• Communicate and coordinate Medical Staff Affairs (MSA) activities on behalf of the Medical Director
• Coordinate and conduct meetings of various stakeholders as needed
• Participate in Business Development, Marketing and outreach activities in conjunction with relevant stakeholders in the hospital
• Easing Packages of all specialties in order to stabilize the over-billing on patients and LOS
• Auditing the patient file in case of complaint from the risk management team or directly from the patient
• Oversee Utilization Management teams and improve workflows for clinical activities
• Defining physician Reimbursement fee for the hospital as per CMS (RVU's) benchmark.

• Maintains a system of confidentiality according to Health System's policies and procedures
• Determines best approach to dealing with managed care plans and over the counter collections for those plans as well as self-pay patients
• Complies with contractual terms agreed by contract
• Exhausted benefits identified in close liaison with re-submission team to ensure maximum recovery from Insurance companies
• Insurance dis-allowance write-offs coordinated with Accounts Receivables department after proper reconciliation
• Responsible for being up-to-date and knowledgeable with regard to diagnostic and procedure coding, and how it affects reimbursement
• Direct human resources activities, including the approval of human resource plans or activities, the selection of doctors or other high-level staff, or establishment or organization of major departments.

• Controlling Communication between Company and Clients Regarding Projects through mails and visits
• Dealing Medical Insurance claims with local & International
• Well aware of insurance policies old and new according to its TOB Optical, Dental, OP/IP etc
• E-claims Submission standardization of diagnosis and procedure codes
• Managing the medical helpline and Reconciliation projects
• Pricing negotiation with providers and empanelment
• Reconciliation and meetings with international assistance companies/ to resolve their issues
• Direct plan, or implement policies, objectives, or activities of organizations or businesses to ensure continuing operations, to maximize returns on investments, or to increase productivity
• Direct or coordinate an organization's financial or budget activities to fund operations, maximize investments, or increase efficiency
• Effective analytic skills aimed at providing judicious claims settlements including deep understanding of maintaining meaningful relationships with providers as well as insurance companies.

1 year experience in Laboratory environment in Clinical Pathology services (CPS) industrial area Dubai

• During this tenure I have covered the following areas
• General Laboratory
• Hematology
• Immunology/Immuno-hematology
• Microbiology
• Urinalysis
• Reduced waste and conserved resources through careful monitoring of inventory levels and timely ordering of supplies.
• Conducted extensive literature reviews to inform experimental design and methodology decisions.
• Contributed to high-quality publications showcasing critical research outcomes developed within our laboratory setting.