SAID ALSAADI MOHAMED IBRAHIM

WORKING AS DERMATOLOGY RESIDENT PHYSICIAN, CHECK PATIENTS, MANAGEMENT
AND TREATMENT

• Managed the blocking of exclusions for all insurance policies, ensuring compliance and accuracy.
• Conducted thorough medical audits on outpatient charges, identifying discrepancies and ensuring fair billing practices.
• Enhanced claim processing by completing inadequate clinical information, improving turnaround times.
• Collaborated effectively with treating doctors to address insufficient diagnoses, facilitating timely patient care.
• Drafted requests for approval by coordinating with treating physicians on deficient case approvals, streamlining the approval process.
• Liaised with company doctors visiting hospitalized patients, ensuring comprehensive care and accurate claims.
• Developed strong relationships with healthcare providers, enhancing communication and operational efficiency in claims auditing.

Worked as Medical Insurance Doctor (HEALTH INSURANCE SPECIALIST, HEAD OF MEDICAL CLAIMS AUDITING

• Managed the blocking of exclusions for all insurance policies received, ensuring compliance and accuracy.
• Conducted thorough audits of all outpatient charges, enhancing financial integrity and reducing discrepancies.
• Completed and rectified inadequate clinical information on claim forms, improving claim approval rates.
• Collaborated with treating physicians to address insufficient diagnoses, facilitating timely patient care.
• Coordinated with doctors for deficient approvals, drafting precise requests to streamline the approval process.
• Liaised with company doctors visiting hospitalized patients, ensuring comprehensive care and accurate documentation.
• Demonstrated strong organizational skills and attention to detail, contributing to efficient medical claims processing.

APPROVAL SECTION HEAD, MEDICAL AUDITOR, REJECTION DOCTOR

• Managed the blocking of exclusions for all insurance policies received, ensuring compliance and accuracy.
• Conducted thorough audits of outpatient charges, enhancing the integrity of medical billing processes.
• Completed and rectified inadequate clinical information on claim forms, improving claim approval rates.
• Collaborated with treating physicians to address insufficient diagnoses, facilitating timely patient care.
• Coordinated requests for approvals with treating doctors, streamlining the approval process for medical cases.
• Liaised with company doctors visiting hospitalized patients, ensuring comprehensive care and accurate documentation.
• Demonstrated strong communication skills and attention to detail, contributing to improved claims management and patient outcomes.

• Conduct comprehensive patient examinations to assess health status and identify medical needs.
• Utilize diagnostic skills to accurately identify diseases and develop effective treatment plans.
• Manage chronic and acute diseases, ensuring optimal patient outcomes through evidence-based practices.
• Oversee the subscription of treatments, ensuring compliance with medical guidelines and insurance protocols.
• Implement follow-up strategies to monitor patient progress and adjust treatment plans as necessary.
• Leverage clinical experience to enhance medical approval processes and streamline claims auditing for insurance purposes.
• Collaborate with healthcare teams to ensure seamless communication between providers and insurance entities.

Worked as G.P (Internal medicine—SURGERY- OB & GYNE -paediatrics - Vaccinations & Emergency)

Worked as G.P at Alazher University Hospitals, Egypt : in Internal Medicine
General Surgery, Gynaecology & Obstetric, Paediatrics & Emergency