Experience

Waseel وصيل

• Saudi Arabia
• IT Services and IT Consulting
• 1 - 100 Employee

• Account RCM/claims Management Specialist

  • Mar 2022 - Present

  ▶️ Providing expert consultation services to healthcare providers on effectively managing their insurance cycles within their establishments. ▶️ Examining and verifying insurance claims to ensure their accuracy and legitimacy before submission to insurance companies. ▶️ Handling the end-to-end processing of insurance claims, including submission to insurance companies. ▶️ Ensuring all insurance claims for submission comply with the precise technical and medical requirements as per the payer's policy. This quality assurance process is critical to avoid any potential issues or misunderstandings with the insurance companies. ▶️ Actively working on reducing the claims rejection rate by improving the overall quality of the claims being submitted. This involves meticulous scrutiny of each claim, rectifying errors, and ensuring complete compliance with insurance policy requirements. ▶️ Regularly reviewing and updating procedures and guidelines to improve the claims submission process and decrease the rejection rate. Show less



pulse medical center

• Abha, 'Asir, Saudi Arabia

• Business Center Manager

  • Jan 2019 - Feb 2022

  ▶️Communicated with insurance companies and established contracts to ensure seamless service provision. ▶️ Coded insurance services in the system, ensuring all details were accurately and promptly entered. ▶️ Processed all insurance billings for patient services,ensuring accuracy and timely submission. ▶️ Prepared and reviewed monthly claims, and submitted them to insurance companies in accordance with set timelines. ▶️ Coordinated and processed payments from insurance carriers, and troubleshooted any issues related to these payments. ▶️ Followed up on insurance claim rejections, conducted reconciliation, and finalized clearances with the companies. Show less



DR Abdullah AL Mozher Medical Center

• Khamis Mishiet Governorate, Saudi Arabia

• Head of Medical Insurance & Claims Supervisor

  • Jan 2017 - Dec 2019

  ▶️ Responsible for insurance verification and provided accurate communications to staff and patients regarding insurance coverage. ▶️ Coded insurance services in the system, ensuring all details were precise and up to date. ▶️ Processed all insurance billings for patient services, ensuring accuracy and timely submission. ▶️ Prepared and reviewed monthly claims and submitted them to insurance companies in a timely manner. ▶️ Coordinated and processed payments from insurance carriers, and troubleshooted any issues related to these payments. ▶️ Communicated with insurance companies about any issues or problems in the department and worked towards effective resolution. Show less



AL-hayat medical group

• Al-Rien, Riyadh Region, Saudi Arabia

• Medical Insurance Representative & Claims Officer

  • Feb 2013 - Apr 2016

  ▶️Initiated and activated insurance policies in the system, ensuring all policy details were accurately inputted and kept up to date. ▶️ Sent medical approval requests to the insurance company and facilitated any necessary follow-up communication to ensure timely approval. ▶️ Prepared and processed monthly insurance claims, maintaining precise records and ensuring all claims were submitted within the stipulated deadlines. ▶️ Handled all daily transactions at the reception, including customer service and administrative tasks as assigned by the department manager. Show less