Relationship Manager
Extensya
Total years of experience :24 years, 5 Months
Plan, direct and coordinate activities involved in the preparation and dispensing of drugs and other pharmaceutical supplies to fill written medication and prescription requests issued by physicians.
Supervise inventory and ordering of pharmacy supplies; approve bills for payment.
Consult with and advise medical staff concerning information obtained on medications.
Direct various personnel functions including, but not limited to, hiring, promotions and vacation schedules.
• Monitor and approve medical reimbursement bills for Out-Patient services (consultations, laboratory tests, pharmacies).
• Manage the documentation of medical claims (filling and archiving).
• Conduct internal audits and systematic reviews of claims and profitability ratios (to ensure the retention portfolio).
• Ensure excellent customer service by following up on “patients’ satisfaction” by building and managing a relation with corporate clients such as Mobily, SABB, SAMBA, NCB, schlumberger, & so many major groups by conducting corporate meetings to discuss employee benefits.
• Answering all the queries from the clients side either through Emails or phone calls. Investigate, develop, and assist in the adjudication of questionable services or appealed claims.
• Responsible for knowledge transfer and continuous training of new employees.
• Serve as advisor to the Chief Medical Officer, while providing medical expertise and new technical review of internal processes and procedures.
• Research and prepare papers on new or significant developments in the areas of concern by Management.
• Meeting with sales team to answer queries & give updates regarding pending, rejected claims, along with CHQs issues.
• Supervised the receiving and registration of all claims from the pharmacies
• Conducted thorough studies for the adjudication of claims.
• Performed detailed analysis of claims, checked the final work for accuracy and adherence to company policies and make a confirmation of credit to each pharmacy.
• Ensured effective and constant communication with the pharmacies and the insured group to better understand their needs and to resolve their problems.
• Approved final disbursement of charges.
• Managed and supervised a 24/7 direct line to solve problems and minimize delays in getting an approval for any medical procedure.
• Supervised and coordinated the work of four (4) qualified pharmacists and check their output.
• Final authority to approve eligible reimbursement for this department.
• Ensured consistent application of company reimbursement policy.
• Supervised the receiving and registration of claims from Qatar General Insurance Company and provided 24/7 claim approval services to the client.
• Managed/supervised ten (10) junior pharmacists.
• Reconciled and prepared daily sales reports and purchase orders and input into database.
• Developed and steward the branch's monthly budget for purchases and sales.
• Serviced all customers on the sales counter and dispensed medicines and prescriptions. Ensured the highest level of customer service and satisfaction.
• Recruited and evaluated potential staff.
• Handled inventory maintenance and refurbishment.
• Prepared and presented tender bids for services and export.
• Coordinated purchases with pharmaceutical companies and wholesale drugstores.
• Conducted training.
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• Provided basic training and a general orientation into hospitals and medical supply chain management.
• Completed 1440 hours of practical training for certification by the Jordanian Ministry of Health.
• Learned about medications, chemo therapy medications and gained an understanding of pharmaceutical components as well as marketing skills.
• Participated in field visits to pharmaceutical factories in Jordan, as they are considered to be the leader in the region.
2000: Graduated with a BA (Pharmacy) ; Applied Science University, Amman, Jordan