Summary
Overview
Work history
Education
Skills
Languages
Timeline
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ABDULRAHMAN AHMED

ABDULRAHMAN AHMED

Dammam,Eastern Province

Summary

Highly experienced professional with over twelve years of experience in the dental field, complemented by extensive expertise in medical insurance operations. Proficient in securing pre-approvals for services requiring prior authorization and well-versed in the protocols of various insurance companies. Thorough understanding of the Saudi Council of Health Insurance (CCHI) policy and familiar with the platforms of insurance companies' portals, Ministry of Health (MOH) platforms, and GOSI for work-related injuries. Demonstrated ability to manage and appeal denied claims effectively, coupled with strong skills in medical coding and claim submission. Thorough knowledge of data analysis skills. Proactive planner and problem solver and good judgment to effectively meet team needs

Overview

18
18
years of professional experience
5
5
years of post-secondary education

Work history

Medical Insurance Specialist

ALZAHRA GENERAL HOSPITAL
Dammam, Eastern Province
09.2023 - 09.2025
  • Pre-Approvals Processing: Responsible for preparing and submitting pre-approval requests for various medical services, ensuring all requirements from insurance companies are met.
  • Accurate Billing: Managed comprehensive billing operations for rendered medical services, ensuring accuracy and compliance with insurance regulations and billing requirements.
  • Claims Processing & Submission: Expert in accurately preparing and submitting insurance claims in a timely manner, and following up on their status to ensure swift reimbursement.
  • Denied Claims Review: Precisely analyzed reasons for claim denials and identified discrepancies or errors.
  • Appeals Management & Correction: Prepared and submitted appeals for denied claims, including correcting errors and providing supporting documentation for successful re-processing.
  • Skilled in medical data analysis

  • Medical Coding: Applied correct medical codes (e.g., ICD-10 and CPT) for diagnoses and procedures to ensure accurate financial claims and compliance with industry standards.
  • Oversaw daily operations to achieve high productivity levels.
  • Used Microsoft Word and other software tools to create documents and clear communications.
  • Used critical thinking to break down problems and evaluate solutions
  • Completed duties to deliver on targets with accuracy and efficiency.
  • Improved efficiency and productivity by acquiring new skills.
  • Worked flexible hours, covering nights, weekends and bank holidays.
  • Consistently arrived at work on time and ready to start immediately.
  • Supported team by demonstrating respect and willingness to help.
  • Cleaned work areas and equipment to maintain faultless hygiene standards.
  • Displayed energy and enthusiasm in fast-paced environment.
  • Delivered exceptional customer service by proactively listening to concerns and answering questions.
  • Applied critical thinking to analyse problems, evaluate solutions and select best decisions.

Dentist

Medicare
Riyadh, Riyadh Region
01.2016 - 05.2023
  • Specialised in root canal treatments to alleviate toothache and discomfort.
  • Regularly updated professional knowledge through continued education courses; maintained best practices at clinic.
  • Collaborated with dental hygienists, enhancing overall efficiency of the practice.
  • Managed comprehensive dental care for diverse patient base to ensure optimal oral health.
  • Performed corrective surgeries on impacted or misaligned teeth to restore functionality and aesthetics.
  • Performed regular teeth cleanings with minimal discomfort for patients.
  • Improved patient comfort by implementing painless dental procedures.
  • Installed crowns and bridges skillfully; restored damaged teeth effectively.
  • Assessed and treated gum diseases promptly, preventing further deterioration or loss of teeth.
  • Kept abreast with latest dental research; implemented findings in daily practice for improved outcomes.
  • Provided emergency dental care on short notice, mitigating severe discomfort or complications.

Dentist

Private Dental Clinic
CAIRO
01.2011 - 12.2015
  • Diagnosed oral conditions, contributing to early detection of serious diseases.
  • Utilised advanced imaging technology during diagnostic processes, resulting in precise treatment plans.
  • Performed regular teeth cleanings with minimal discomfort for patients.
  • Provided emergency dental care on short notice, mitigating severe discomfort or complications.
  • Conducted educational sessions for patients, promoting better oral hygiene habits.
  • Regularly updated professional knowledge through continued education courses; maintained best practices at clinic.
  • Managed comprehensive dental care for diverse patient base to ensure optimal oral health.
  • Communicated clearly with patients about their treatment plans and aftercare instructions; fostered trust and compliance.
  • Collaborated with dental hygienists, enhancing overall efficiency of the practice.
  • Assessed and treated gum diseases promptly, preventing further deterioration or loss of teeth.
  • Diagnosed and treated dental conditions, delivering personalised care to patients.
  • Implemented infection control protocols to maintain safe clinical environment.
  • Performed cleanings advised patients to improve dental hygiene.
  • Communicated treatment options to patients to support informed decision-making.
  • Created tailored short-term orthodontic plans to meet patient needs.
  • Established policies and procedures for dental practice team, informed employees of guidelines and supervised daily work.
  • Offered exceptional facial aesthetics and teeth whitening services.

Dentist

Armed Forces Hospitals
CAIRO
01.2008 - 10.2010
  • Streamlined appointment booking system, improving patient satisfaction levels.
  • Provided emergency dental care on short notice, mitigating severe discomfort or complications.
  • Regularly updated professional knowledge through continued education courses; maintained best practices at clinic.
  • Installed crowns and bridges skillfully; restored damaged teeth effectively.
  • Diagnosed oral conditions, contributing to early detection of serious diseases.
  • Communicated clearly with patients about their treatment plans and aftercare instructions; fostered trust and compliance.

Education

Bachelor of Oral and Dental Surgery (BDS) - Dentistry

October 6 University
CAIRO
05.2001 - 09.2006

Skills

  • Public speaking
  • Team building
  • Strategic planning
  • Leadership
  • Resourcefulness
  • Quality Assurance
  • Google Workspace

Languages

English
Advanced

Timeline

Medical Insurance Specialist

ALZAHRA GENERAL HOSPITAL
09.2023 - 09.2025

Dentist

Medicare
01.2016 - 05.2023

Dentist

Private Dental Clinic
01.2011 - 12.2015

Dentist

Armed Forces Hospitals
01.2008 - 10.2010

Bachelor of Oral and Dental Surgery (BDS) - Dentistry

October 6 University
05.2001 - 09.2006

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ABDULRAHMAN AHMED