Mustapha Hemeda, Approvals department manager

Mustapha Hemeda

Approvals department manager

Misr healthcare network

Location
Egypt - Cairo
Education
Bachelor's degree, Medicine & Surgery
Experience
13 years, 2 Months

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Work Experience

Total years of experience :13 years, 2 Months

Approvals department manager at Misr healthcare network
  • Egypt - Cairo
  • My current job since July 2018
Claims Supervisor at Globemed
  • Egypt - Cairo
  • February 2015 to June 2018

I 'm working as an approval doctor at PSOD for Globemed Egypt

Medical Claims Officer (Approvals Doctor) at Next Care
  • Egypt - Cairo
  • June 2014 to December 2014

1- Processing online medical requests from KSA ( Saudi NextCare has an office in Egypt )
2- Claims medical auditing

I was trained for one month at Saudi NextCare in Egypt and worked there for 6 months to be prepared to work at Saudi NextCare HQ in KSA, But unfortunately they couldn't bring me a Visa to travel

Assistant PC Director at El Dar Hospital Qubaa
  • Saudi Arabia - Medina
  • February 2013 to May 2014

I worked at OPD of the hospital as an assistant OPD manager, My duties included:

1- train all OPD staff (Doctors, nurses and Receptionists) and orient them on how to deal with UCAFs (Claim forms).
2- Claim form auditing and finalizing from various clinics at OPD
3- confirm and handle new polices and contracts from insurance companies.
4- continuous communication and meetings with insurance company to discuss price list, adding service, revise rejections.

(reason of leaving : we did not agree upon contract renewal)

Hotline supervisor at Uni-care
  • Egypt - Cairo
  • August 2012 to February 2013

My main task was to manage inpatient cases (Admission-extension- operations- various medical procedure inside the medical facilities)
checking the eligibility of pt, ceiling limits, medical reports.

Medical Claims Officer (Approvals Doctor) at Operations
  • Egypt - Cairo
  • March 2011 to August 2012

My main job was to Audit Individual claims (Reimbursement), I Also worked as an approval doctor at the Approval Department of the company

Education

Bachelor's degree, Medicine & Surgery
  • at Ain shams University
  • December 2010

Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.)

Specialties & Skills

Insurance
Approvals
Computer Skills
medical analysis
Medical data entry
Communication skills
outspoken

Languages

Arabic
Expert
English
Expert
German
Beginner

Hobbies

  • Swimming
  • Football
  • Atheletics
    I was part of the university team, I have a personal 100 m running of 10.5 sec