Laura Bou Jaoude

Senior Compliance Officer / Claims audit and QA department at GlobeMed Lebanon
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Contact Information
us****@****om
(386) 825-5501
Location
Mount Lebanon Governorate, Lebanon, LB
Languages
  • Arabic Native or bilingual proficiency
  • French Full professional proficiency
  • English Full professional proficiency
  • German Limited working proficiency

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Bio

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Credentials

  • Medical insurance Coding specialist/coder
    Saint Joseph University of Beirut
    Nov, 2021
    - Nov, 2024
  • Certified Internal Forensic Healthcare Auditor
    The American institute of healthcare compliance
    Jun, 2019
    - Nov, 2024
  • BCLS
    Lebanese Red Cross
    Jun, 2011
    - Nov, 2024

Experience

  • GlobeMed Lebanon
    • Hospitals and Health Care
    • 100 - 200 Employee
    • Senior Compliance Officer / Claims audit and QA department
      • Feb 2021 - Present

      • Led and supervised the Covid claims audit unit, a project funded by the World Bank in collaboration with Lebanese Ministry of Public health (MoPH)• Developed and implemented guidelines and protocols in accordance with the Ministry of Public Health’s standards• Managed inquiries and requests of the World Bank representatives• Provided periodic reporting to the MoPH and the World Bank representatives

    • Compliance officer / Claims audit and QA department
      • May 2018 - Jan 2021

      • Implemented new guidelines for pre and post payment claims audit • Updated existing protocols to improve operations’ outcomes and efficiency• Trained all concerned staff members regarding updated and new guidelines• Developed new strategic planning methodology and coordinated all related activities• Identified fraudsters and abuse patterns within company’s network of providers that led to major savings and recoveries

    • Senior nurse delegate
      • Jan 2017 - May 2018

      • Served as in charge of the company’s field office at Hotel Dieu de France hospital• Managed the office, organized and set priorities for the workflow• Handled, coordinated and followed up on office supplies, maintenance and related needs• Coordinated with all hospital’s departments to ensure patient’s ultimate satisfaction• Trained new candidates enrolled in the PSD department when needed• Maintained the bills cycle within deadlines• Validated and coded discharged patients’ medical files according to ICD 10– WHO • Assisted in conducting quality control over claims

    • Nurse delegate
      • Nov 2013 - Jan 2017

      • Made necessary administrative and medical clearance to provide adequate medical decisions for IN, Ambulatory, Pharmacy and ER claims as per protocols in place• Visited patients and checked their identity and their medical status• Followed up on patients’ progress notes, prolongations, results and discharge status• Handled clients’ complaints and inquiries • Identified false declaration cases • Recognized possible areas of abuse in the billing system of some providers• Escalated suspicious claims subject to fraud/abuse

  • Saint Joseph University of Beirut
    • Lebanon
    • Higher Education
    • 700 & Above Employee
    • Course Instructor
      • Nov 2021 - Nov 2022

      Ethics and Fraud detection Ethics and Fraud detection

  • Hôtel-Dieu de France
    • Lebanon
    • Hospitals and Health Care
    • 500 - 600 Employee
    • Critical Care Registered Nurse
      • Jun 2009 - Oct 2013

      • Evaluated critical illness level for admission• Admitted patients to the unit in accordance with the severity of their cases (triage)• Assisted in daily rounds of physicians• Discussed patient’s status, evolutions and health status changes with physicians• Reported and documented patient’s progression and deterioration• Executed advanced life support protocol for patients with cardiac arrest• Performed hourly check up on patients• Supervised trainees and newly enrolled candidates• Supported medical residents and interns during their rotation in the departments• Performed daily patient care including administration of treatment, wound care, insertion of catheters … • Helped doctors during medical acts as per protocols (e.g: intubation, bronchoscopy…)

Education

  • Lebanese University - Faculty of Public Health
    Master of Public Health - MPH, Public Health - Education and promotion of health
    2012 - 2014
  • Lebanese University - Faculty of Public Health
    Bachelor of Science - BS, Nursing Science
    2005 - 2009

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