Nahed Salamah
RCM Account Executive at Waseel ASP Ltd.- Claim this Profile
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Bio
Experience
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Waseel وصيل
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Saudi Arabia
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IT Services and IT Consulting
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1 - 100 Employee
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RCM Account Executive
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Feb 2021 - Present
- Be the first and main point of contact for all client needs, software concerns, and training.- Be responsible for maintaining frequent and consistent contact with the client to measure the client’s satisfaction and utilization of the HIS system.- Build your clients’ monthly financial performance reporting and review these reports with the client on a monthly basis.- Travel to client sites for relationship building.- Build out and document practice and company specific protocols and processes.- Help develop and suggest new reporting tools needed to analyze a client account.- You will provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to the Executive team or clients as needed.- Attend relevant seminars to remain abreast of current issues regarding revenue cycle management, NAPHIS Billing System and CCHI.- Learn about and adhere to all practice policies related to revenue cycle management, NAPHIS Billing System and CCHI.- Supervise an assigned AR analyst to ensure consistent audits for our contracted Medical Provider.
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Insurance Director & Business Development Manager
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Sep 2011 - Jan 2020
- Manage operations, productivity and contracting with insurance companies.- Create and modify procedures and documents related to policies.- Assist in claims management.- Identify and analyze risks associated with policies.- Achieve target budgets.- Minimize risk of financial loss.- Obtain and oversee company insurance or related funds that management uses to cover costs such as disability benefits.- Direct information for claimants.- Preside over claims investigations.- Review insurance policies.- Manage insurance data for reports.- Determine premium rates.- Ascertain cash reserves necessary to ensure payment of future benefits.- Planning and overseeing new marketing initiatives.- Researching organizations and individuals to find new opportunities.- Increasing the value of current customers while attracting new ones.- Finding and developing new markets and improving sales.- Developing quotes and proposals for clients.- Developing goals for the development team and business growth and ensuring they are met.- Training personnel and helping team members develop their skills.- Keep records of sales, revenue, invoices etc.- Provide trustworthy feedback and after-sales support.- Arrange business meetings with prospective clients.- Negotiate deals.
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Admission Office and Contract Manager
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Jan 2010 - Sep 2011
- Ensures patients are admitted in accordance with hospital policies and procedures- Provides case management services.- Develops and achieves departmental goals and objectives by gathering patient, demographic, insurance and financial information.- Prepares budgets to enable admissions department to meet financial goals, keeps track of expenditure and beds and enforces corrective action when necessary.- Manages bed availability and occupancy to maximize bed occupancy and patient traffic according to hospital and federal regulations and guidelines.- Reduces admissions conflicts and discrepancies by collaborating with physicians and assigns beds according to priority- Performs regular audits to ensure proper handling and accuracy of all patient data to ensure revenue for hospital.- Communicates with patients, their families, proxies and admitting staff to ensure rules, regulations and procedures are followed.- Improves delivery of patient care by integrating admissions procedures with other care staff, including working with various hospital departments- Adheres to and upholds JCI policies to protect the organization.- Continuously works to achieve hospital goals. Accepts ownership for actions and decisions, accomplishments and actively explores new opportunities on the job to enhance skills and knowledge.- Writing, evaluating, negotiating and executing various contracts covering a range of transactions- Creating and maintaining relationships with customers.- Maintaining correspondence and documentation related to contracts.- Communicating and presenting information to stakeholders regarding contracts.- Monitoring contracts and moving forward with close-out, extension or renewal of contracts.- Problem-solving contract-related issues
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Claims and ARAMCO Billing Officer
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Feb 2007 - Nov 2010
- Evaluates and processes claims in accordance with insurance policy terms and conditions, company policies and procedures according to productivity and quality standards.- Ensures that targets are met for department Turnaround time, Quality and Productivity.- Identify and report back any type of claims observation or issues that may affect the process.- Collect and analyze claims data to identify and resolve errors, delayed claims, and processing issues. Providing recommendations to take steps to improve the claims processing quality standards and productivity.- Analyze reports from the administrative software for provider and member utilization trends and identification of areas requiring further management.- Support the Team leader / Manager in implementation of quality assurance programs in order to maintain standards of quality and minimize fraudulent cases.- Handling medical related call queries.- Maintain confidentiality with regard to the information being processed, stored or accessed.- Completes other projects and duties as assigned.- Coordination of monitoring the medical care provided to SAUDI ARAMCO beneficiaries.- Respond to SAUDI ARAMCO inquiries or concerns- Executing the sick leave and outpatient/Inpatient referral policy.- Ensuring availability of the pharmaceutical and supplies to SAUDI ARAMCO beneficiaries.
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Education
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King Faisal University
Bachelor’s Degree / Business Administration, Business Administration and Management, General -
Bahrain Institute of Banking and Finance (BIBF)
Aword general insurance, Insurance -
Dallah Training Center
Workshop attended in Insurance Necessity or Reality, Insurance -
Pebble Hills University
Master's degree / MBA - Health Care Management, Business Administration and Management, General -
CCHI (Council of Cooperative Health Insurance)
Certificate ICD 10 am devlopment, Insurance -
Al Khiyam Training Center
Workshop attended in Hospital Managements and Public Relation, Hospital and Health Care Facilities Administration/Management -
Direct English Institute
Diploma’s Degree / English, English Language and Literature, General -
New Horizon Institute
Diploma’s Degree / Programming Technique, Computer Programming -
New horizon
Diploma of programming technique -
King Faisal University