Global Operation Manager(International Patient Services)
Bupa Arabia
Total years of experience :11 years, 11 Months
*Adjudications for outpatient and inpatients medical requests at biggest health care provider in Jeddah ( Dr Soliman Fakeeh Hospital) as stationed Insurance doctor.
*Reporting fraud and Ant selecting cases for final decision. .
* Handling all customer objections and rejection recovery cases as part of Customer Experience daily tasks.
*Managing VIP requests with adequate response time (maximum 5 minutes).
*Monthly awareness meeting with treating doctor for CCHI policy and accredited medical Guideline with Consultants and insurance doctors and quality management doctors.
*Customer service in insurance training and medical background awareness for new delegates and administrative officers.
Daily Tasks:
*Adjudications for outpatient and inpatients medical requests and recording a new record 200 requests per day adherent to CCHI “Saudi Policy” with full quality ICD coding .
*Reporting fraud and Ant selecting for final decision. .
*.Finalize pending cases with achieving marvelous effect on the Response time.
*Managing VIP requests with adequate response time (maximum 5 minutes).
Initiative:
*Taking part of preparing training booklet for Specialized Medical Officer (SMO).
*Taking part of Kaizen project for pre-authorization department improvement.
*Taking part of Net Promoting Scale (NPS) calls to identify evaluation percentage of our customer satisfaction.
*Monthly short notes done as reminder posters.
Achievements:
1- Performance of the Annual Evaluation for 2014 and 2015 I was nominated as full achieved with extra activity with rating.3 with Zero tolerance in Quality Check.
2- Nominated to be Senior SMO.
3- Nominated to be one of full achieved SMO in answering of weekly QUIZ sent by quality department.