Abrar Almuhandeb
Medical Insurance
Dammam
Summary
Highly disciplined employee with main goal to maximize profits for the company and minimize losses by competent analysis of insurance cover applications. Equipped with solid background in the insurance industry, as well as strong analytical, research. Possessing strong experience as an Insurance Underwriter and Medical Claims auditor for two different companies. imperative first-hand knowledge and sharp medical risk assessment as well decision-making abilities.
Overview
6
6
years of professional experience
Work History
Medical Auditor/Medical Underwriter
Gulf Union
Dammam, Eastern Province
2021.04 - Current
- Conduct medical underwriting analysis
- Prepare policies by insuring all risk factors have been taken into consideration
- Review and prepare quotations to process contract within authority limit
- Determine customer’s loss ratio and reporting it to management with recommendations
- Investigate suspicious dental claims in regard to fraud or malpractice in coordination with higher management.
- Highlighting & escalating abusive trends, patterns,or any unwarranted/Fraudulent practices to the concerned departments for corrective actions.
- Audit Dental claims(Direct Billing/ Reimbursement) as per policy, provider agreement and medical necessity.
Medical Case Manager
Total Care Saudi
2019.03 - 2021.04
- Handling dental and medical cases
- Approving cases in timely manner
- Working on Hajj/Ummrah insurance program
- Handling GOSI cases
- Auditing cases with medical service providers
Intern
Safwa Hospital
2018.07 - 2018.08
- Working in prosthodontic & pedodontic clinics
Intern
Jubail central Hospital
2018.03 - 2018.04
- Worked in surgery & endodontic clinics
Riyadh Colleges of Dentistry & Pharmacy
2017.06 - 2018.01
- Completed 3 comprehensive cases
- Coordinating with patient for their appointments
- Handling materials as well as appointment schedule
- PROJECTS
- Attended international dental conference & exhibitions around GCC region
Education
Bachelor Of Dental Surgery -
Riyadh College of Dentistry & Pharmacy
2011.05 - 1 2018
Skills
* Maintained knowledge of all recent events and trends within the underwritten industry
* Ability to develop technical underwriting and maintaining accuracy
* Remarkable knowledge of CCHI policies and regulations
* Hands on experience in medical underwriting for insurance
Timeline
Medical Auditor/Medical Underwriter
Gulf Union
2021.04 - Current
Medical Case Manager
Total Care Saudi
2019.03 - 2021.04
Intern
Safwa Hospital
2018.07 - 2018.08
Intern
Jubail central Hospital
2018.03 - 2018.04
Riyadh Colleges of Dentistry & Pharmacy
2017.06 - 2018.01
Bachelor Of Dental Surgery -
Riyadh College of Dentistry & Pharmacy
2011.05 - 1 2018