Consultant of Insurance Operations/ TPA Operations
AlphaSights
Total years of experience :27 years, 1 Months
Consulting for international clients regarding medical and life and P.A insurance in Egypt and the middle East.
TPA Consultation for international clients.
Provide consultation regarding insurance market in Egypt.
Provide details regarding Claims, C.S and Approvals for medical insurance in Egypt.
Provide details regarding Life/P.A insurance market in Egypt.
Teaching Strategic Management to MBA students from Medical and Engineering Backgrounds.
Preparing course material.
Evaluating students and making sure knowledge objectives are met.
Manage the entire medical service to 120, 000+ beneficiaries.
Assess, train and follow up on all departments related to medical insurance.
Provide medical advice to clients as head of medical committee.
Assess medical provider network and manage.
Ensure integrity of approvals and call center units and apply standards.
Start the Claims department, Approvals department and Customer Service department from scratch.
Provide all documentation (e.g. claim form, indemnity form, PBM training material) for all three departments.
Staffing and training of all three departments.
Serving 250, 000 + insured in PBM (Pharmacy Benefits Management) and 3, 500 full
Managing different sub-units involved (Claims medical/Life/P.A, Approvals, C.S)
Managing 100+ employees at different levels.
Maintaining service level for entire growing portfolio.
Managing intra and inter departmental relationships.
Managing Life/Disability/Medical Claims for 250, 000 insured.
Managing Life/Disability claims for individual portfolio.
• Exchange Domain Administration. Windows NT administration
• Web Designing
• Video Editing (Premiere)
• Multimedia assembly
• Research Assistant MOIS courses
- Governmental and private work as a dentist.
- Surgeon of Maxillofacial surgery.
Fully Accredited School of Business. 16 modules, 8 Core and 8 elective.
(Diploma with honors) Professional Certificate in I.T & Programming.
Faculty of Oral & Dental Medicine & Surgery. Bachelor’s Degree. Grade Good.
Previously Manor House & Schools in the U.K