Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Aya Mohamed

makkah,Saudi Arabia

Summary

Proactive medical pre-authorisation specialist with clinical pharmacy experience and strong knowledge of insurance protocols. Managed claims workflows across complex insurance portals to reduce claim rejection rates. Communicated effectively with medical staff and insurance providers to support timely, high-quality care.

Overview

2
2
Languages
1
1
year of professional experience

Work History

Mediacal pre-Authorization Specialist

ALSAEDY POLYCLINICS
Makkah, Saudi Arabia
11.2025 - Current
  • Submitted and tracked prior authorisation requests for medicines and procedures accurately.
  • Reviewed medical prescriptions and treatment plans for compliance with insurance policies and guidelines, ensuring timely approvals.
  • Communicated with health insurers to clarify coverage details and unblock approvals.
  • Investigated rejected insurance claims, compiling necessary medical justifications and documentation to facilitate successful resolution.

Education

Certificate of Higher Education - Pharmaceutical

Faculty Of Pharmacy Zagazig University
Zagazig
01-2023

Skills

  • Prior authorisation Management
  • Claims processing
  • Pharmacology & Medical Terminology
  • NPHIES Platform & Insurance Portals
  • Basic Medical Coding (ICD-10 & CPT)
  • Data analysis and interpretation
  • Excel proficiency
  • Client relationship management
  • Creative problem-solving

Languages

Arabic
First Language
English
Advanced
C1

Timeline

Mediacal pre-Authorization Specialist

ALSAEDY POLYCLINICS
11.2025 - Current

Certificate of Higher Education - Pharmaceutical

Faculty Of Pharmacy Zagazig University
Aya Mohamed