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waly algousi, Account Manager

waly algousi

Account Manager·Egyptian Steel Fabrication Co. (ESF)

United Arab Emirates

Bachelor's degree, Medical Engineering

Work experience

Total years of experience: 15 years, 11 months

Account Manager

December 2023 - Present

Egyptian Steel Fabrication Co. (ESF)

Cairo, Egypt

December 2023 - Present

• Manage company insurance policies, including property, equipment, liability, and employee medical
coverage.
• Serve as the key liaison between ESF and insurance providers, ensuring adequate protection and
compliance.
• Conduct risk assessments for projects and assets to determine proper coverage and minimize financial
exposure.
• Oversee policy renewals, negotiate premiums and terms, and handle claims efficiently.
• Collaborate with finance, HR, and operations teams to ensure accurate documentation and smooth
claim settlements.
• Prepare regular insurance and risk reports to support management decisions and cost optimization.

Company industry:
Insurance & TPA

Senior Account executive

April 2021 - March 2026

Aetna International

Dubai, United Arab Emirates

April 2021 - March 2026

Communicates product features and fundamental components to the organization that reflects the product
and responds to the needs of various stakeholders
Acted as the primary point of contact for a portfolio of corporate clients, fostering strong relationships and
ensuring their needs were met.
I coordinate and handle ad hoc account manager (AM) requests.
I initiated and maintained partnerships with others throughout the organization. I encouraged
cooperation by promoting common goals and building trust. Structures the collection of data
relevant to complex or cross-functional issues
Integrated data from multiple sources into a logic framework that supports decision- making
Conducted regular check-ins and meetings with clients to understand their evolving insurance
requirements and to provide updates on policy changes and coverage options.
Worked closely with internal teams to ensure timely and accurate implementation of client specific
insurance solutions.

Company industry:
Insurance & TPA
Job role:
Accounting and Auditing

Case Management Associate

June 2016 - March 2026

MINA

Dubai, United Arab Emirates

June 2016 - March 2026

• Working within the Member Assistance contact center, investigate, consider and pre- authorize
treatment globally.
• Professionally manage inbound and outbound telephone, fax and email correspondence with
customers, brokers, suppliers and all other interested parties ensuring that appropriate and timely
communication is maintained at all times.
• Complete eligibility verification, escalate medical information to Clinical Case Managers,
determine coverage, identify discrepancies, and apply all cost containment measures
• Triage and priorities caseload considering urgency, geographical location and service level.
Investigate claims for possible abuse and fraud.
• Ensure compliance with requirements of regional compliance authority/industry regulator.
Adheres to international privacy policies, practices and procedures.
• Strives to deliver consistently excellent customer service internally and externally Contact
Medical/Dental providers, hospitals, and clinics in US to solve participants issues.

Company industry:
Hospitality & Accomodation
Job role:
Administration

Senior Product & Marketing Consultant

January 2019 - January 2021

Aetna International

Dubai, United Arab Emirates

January 2019 - January 2021

Coordinate and organize events with Marketing for launching products.
• Collaborates with market segment to develop and implement plans to achieve segment product
strategies.
• Establishing contacts through all levels of the Companys Management and with other external
organizations to identify best collaboration opportunities in order to ensure proper implementation of the
Companys PR and social responsibility programs. Compliance and promoting of the Companys
Management Systems is an essential element in carrying out the activities of this job.
• Lead client-facing projects and work closely with executive stakeholders to set strategic roadmaps and
ensure timely discovery and delivery of valuable, desirable and feasible products
• Leading designs sprints and consult clients on how to prioritize their product roadmaps.
• Research, analyze, recommend and implement new technologies, standard processes, tools and
techniques Evaluate emerging and disruptive technologies that will evolve and enhance the enterprises
Virtual Health capabilities.
• information Delivers technical presentations to peers, leadership team, sales executives, clients,
prospects, etc. Communicates with the Project Manager and Technical Teams and support Technical
Architects.
• Plan, lead and organize the activities of the PR & Events Section to ensure efficient and timely
achievement of the planned activities of the section.
• Plan, Supervise and coordinate the organizing of the Companys events. Provide leadership in the
planning, coordination, and evaluation of the Companys various events.

Company industry:
Other Healthcare Services

Process Associate

April 2013 - March 2016

Genpact – “Aetna Medical Insurance”

Dubai, United Arab Emirates

April 2013 - March 2016

•• Processes medical service requests and medical inquiries with
strict adherence to confidentiality agreements and policies and procedures.
•Contact Medical/Dental providers, hospitals, and clinics in US to
solve participants’ issues and to provide assistance when required.
• Verify check payment status and liaison with claims team to
stop/re-issue payments for the participants
• Review insurance policy terms in order to determine whether a
particular service is covered by insurance.
• Maintains files, logs, lists, manuals, and indexes of clients or
provider enrollments, claims, payments, work area guidelines, authorized
treatment procedures, corresponding fees, and other records.
• Answer questions and offer other information, as requested, to provide
break down of medical benefits to participants
• Issue insurance cards for participants upon request.
• Verify medications coverage, contracted Doctors, hospitals, and
pharmacies for participants.
• Contact customers in order to respond to inquiries or to notify them of
claim investigation results and any planned adjustments.
• Contact Medical/Dental providers to solve participants’ issues and to
provide assistance when required.
• Resolve customers service or billing complaints by performing activities
such as exchanging merchandise, refunding money, and adjusting bills.
• Service and a positive impression of the organization.
• Check to ensure that appropriate changes were made to resolve customers
problems.
• Recommend improvements in products, packaging, shipping, service, or
billing methods and procedures in order to prevent future problems.

Company industry:
Insurance & TPA
Job role:
Administration

Process Associate

January 2013 - January 2016

Genpact Services LLC -UAE

Dubai, United Arab Emirates

January 2013 - January 2016

• Processes medical service requests and medical inquiries with strict adherence to confidentiality
agreements and policies and procedures.
• Contact Medical/Dental providers, hospitals, and clinics in US to solve participants issues and to
provide assistance when required.
• Verify check payment status and liaison with claims team to stop/re-issue payments for the
participants. And Issue insurance cards for participants upon request.
• Review insurance policy terms in order to determine whether a particular service is covered by
insurance.
• Contact customers in order to respond to inquiries or to notify them of claim investigation results
and any planned adjustments.
• Resolve customers service or billing complaints by performing activities such as exchanging
merchandise, refunding money, and adjusting bills.
• Recommend improvements in products, packaging, shipping, service, or billing methods and
procedures in order to prevent future problems.

Company industry:
Insurance & TPA

Customer service

November 2011 - April 2013

Roads and Transport Authority

Dubai, United Arab Emirates

November 2011 - April 2013

 Keep a strong relationship with the clients and preparation of daily reports.
 Train the new and existing agents on soft skills, customer service, and knowledge Base.
 Renew vehicles registration and license throw SDDI system
 Make sure everything is running as per the service level and up to the requirement of client.
 Follow up with customers and make sure that their cases are solved on time. Providing feedback on the same.
 Answer phones professionally
 Guide customer and in essence to provide exceptional customer service.
 Research required information using available resources
 Handle and resolve customer complaints
 Provide customers with product and service information
 Process orders, forms and applications
 Follow up customer calls where necessary

Company industry:
Call Centers & Customer Care Outsourcing
Job role:
Customer Service and Call Center

Customer Services Representative

November 2011 - January 2013

Roads and Transport Authority -UAE

Dubai, United Arab Emirates

November 2011 - January 2013

• Train the new and existing agents on soft skills, customer service processes, and knowledge base.
• Continuously monitor the performance and be responsible to maintain the department KPIs &
SLAs as agreed.
• Monitor and ensure that workflow process/ protocols put in place for the Department are adhered
to Ensure that all complaints, suggestions, and feedbacks raised by the members, and clients are
logged in properly in the complaint resolution portal and into RTAs CRM system. proper follow up
is taken within predefined timelines.
• Assisting customers with registrations, renewals, permits, Nol‑card payments, traffic fines, vehicle
licensing, and transport queries.
• Data Entry & Guidance: Accurately entering customer information and required documents into
RTA systems. Issuing documents such as vehicle test certificates or transaction confirmations at
counters, particularly at vehicle registration or testing centers.
• Ensuring all payments align with system printouts and handing over cash securely at shift end.

Company industry:
Motor Vehicle Passenger Transport

Medical Engineer

November 2010 - October 2011

Al Shaab Hospital

Khartoum, Sudan

November 2010 - October 2011

• Biomedical equipment technicians install, maintain, repair medical equipment, Installation
equipment of laboratory.
• Prepares biomedical reports by collecting, analyzing and summarizing information
andtrends.
• Test and calibrate parts, identifying parts for repair or replacement.
• Perform preventative maintenance on critical equipment to ensure high-quality treatment for
patients.
• mechanical and technical skills to diagnose problems and conduct repairs. The profession
also requires communication and time-management skills to quickly and effectively ensure
the safety of medical equipment.
• Ensure compliance with safety regulations and policies, Ensured documentation is complete,
timely, and accurate Repair and replace complex biomedical equipment and systems
• Install and adjust a variety of biomedical and research equipment and Diagnose equipment
malfunctions with accuracy and precision

Company industry:
Medical Hospital
Job role:
Engineering

Medical Engineering

May 2010 - August 2011

alshab hospital

Khartoum, Sudan

May 2010 - August 2011

 Maintenance of Medical Equipment and marketing of Medical Equipment

Company industry:
General Engineering Consultancy
Job role:
Engineering

Education

University of Science & Technology

November 2009

November 2009

Bachelor's degree, Medical Engineering

Sudan

third degree

University of Science and Technology

July 2009

July 2009

Bachelor's degree, Engineering.

Sudan

Skills

Insurance
Expert
Insurance
Expert
Biomedical Engineering
Expert
Biomedical Engineering
Expert
Medical Records
Expert
Medical Records
Expert
Marketing
Expert
Marketing
Expert
Customer Service
Expert
Customer Service
Expert
 Marketing & promotion skills
Intermediate
 Marketing & promotion skills
Intermediate
 Ability to work under pressure & meeting deadlines  Good communicator
Expert
 Ability to work under pressure & meeting deadlines  Good communicator
Expert
Insurance
Expert
Insurance
Expert
Biomedical Engineering
Expert
Biomedical Engineering
Expert
Medical Records
Expert
Medical Records
Expert
Marketing
Expert
Marketing
Expert
Customer Service
Expert
Customer Service
Expert
CORPORATE SOCIAL RESPONSIBILITY
Intermediate
CORPORATE SOCIAL RESPONSIBILITY
Intermediate
CUSTOMER RELATIONSHIP MANAGEMENT
Intermediate
CUSTOMER RELATIONSHIP MANAGEMENT
Intermediate
DESIGN PORTFOLIO
Intermediate
DESIGN PORTFOLIO
Intermediate
INSURANCE POLICIES
Intermediate
INSURANCE POLICIES
Intermediate
LEADERSHIP
Intermediate
LEADERSHIP
Intermediate
MARKET RESEARCH
Intermediate
MARKET RESEARCH
Intermediate
MARKETING
Intermediate
MARKETING
Intermediate
PRODUCT DESIGN
Intermediate
PRODUCT DESIGN
Intermediate
PROJECT MANAGEMENT
Intermediate
PROJECT MANAGEMENT
Intermediate
PUBLIC RELATIONS
Intermediate
PUBLIC RELATIONS
Intermediate

Languages

English

Expert

Arabic

Native Speaker

Training and Certifications

Certifications
Medicines Electronics Equipment Fire Safety
Fundamentals and Fire Warden certificates
Anesthesia machine course
Medical Diagram Tracing and Analysis.

Hobbies and interests

reading ,sport