Process medical manager -preauthorisation-Health insurance
Bupa Arabia
Total years of experience :21 years, 1 month
Leading medical team in achieving their deliverables with high quality and defined policy with customer satisfaction
•Sharing in implementing guidelines for preauth in Bronchial asthma-FUO-Neonatal admission.
•Continuous CME lectures to Bupa Arabia staff.
•Issuing a medical newsletter on monthly basis to be distributed amongst Bupa Arabia
•Fighting Hospital and member’s fraud, antiselection and undeclared condition.
• Reporting directly to Preauthorization Manager
Responsibilities (as part or Preauthorization Team):
• Adjudicate all requests received from the providers’ regarding BUPA policy & medically.
• Case management.
• Cost control.
• Ensure proper services delivery.
• Fraud detection.
• Anti selection detection.
Registered as GP from health spciality
Risdent Doctor in paediatric dept, University Hospital
I have 1st part master degree in pediatrics
