Dr. Mohamed Amer
Jeddah,Saudi Arabia
Summary
Focused Senior Revenue Cycle Manager with impressive track record in collaborative, cross-functional teamwork within high-pressure environments. Adept at project planning and managing multiple accounts at once. Dedicated to improving company sales goals and meeting business objectives.
Overview
12
12
years of professional experience
7
7
years of post-secondary education
1
1
Certification
Work history
Senior Revenue Cycle Manager
Al-Abeer Medical Group
Jeddah, Saudi Arabia
07.2025 - Current
- Manage the Revenue Cycle Operation targeting increment in Cash Flow rates and minimizing Denial Ratio.
- Review new projects related to NPHIES Mapping and Activation.
- Follow up all process related to Approval , Billing , Contracting , Denial follow up and Reconciliation
- Assure direct and continuous communication with insurance companies provider relation Managers to solve issues related to Daily RCM Operations.
- Review on weekly basis the projects owned by the RCM Managers in Hospitals.
- Follow up Contract Renewals with insurance Companies assuring achievement of the best agreement related to the group network against targeted flow rates and Business revenue.
- Delegate tasks efficiently to maximize productivity.
- Working on department efficiency by improving operational processes.
- Supervising project timelines for timely project completion.
- Establish and Monitoring KPIs to assess operational effectiveness and driven decision-making.
- Secure new business opportunities to successfully meet growth targets like referral matrix process.
- Lead and implement award initiatives to support workflow.
- Hold scheduled Meetings with team members and other departments to ensure smooth workflow.
- Review new projects related to NPHIES Mapping and Activation.
- Follow up all projects related to Approval , Billing , Contracting , Denial follow up and Reconciliation.
- Follow up the process of MOH referral by CNHI managed by Globemed Saudi tracking the cases acceptance and collaborating with the TPA to get approvals in accepted SLA.
- Assure direct and continuous communication with insurance companies provider relation Managers to solve issues related to Daily RCM Operations.
- Review on weekly basis the projects owned by the RCM Managers in Hospitals.
- Follow up Contract Renewals with insurance Companies assuring achievement of the best agreement related to the group network against targeted flow rates and Business revenue.
- lead performance reviews and identify areas of improvement.
- collaborate with Sales and Marketing teams targeting the most effective policies in insurance companies depending on the regions , patient classes and the network of the provider.
Senior Revenue Cycle Manager
Comprehensive Family Medical Group
, Saudi Arabia
01.2022 - 07.2025
- Implementation of the strategic plan for RCM Operations and reviewing the achievement.
- Discuss and perform root cause analysis to solve the issues interfering with the concerned department.
- Follow up KPIs of pre-authorization requests submission assuring submission within the accepted TAT and resubmission of rejected Approval requests , Claims submission in due dates with the highest Quality levels.
- Comparing and reviewing the performance of the Resubmission unit and reviewing closing % with the payers
- Review contract status for each payer
- Referral Matrix follow up.
- Establish NPHIES Mapping and NPHIES Activation as per CHI Regulation
- Establish and monitor key performance indicators KPIs to assess operational effectiveness and drive decision-making.
Revenue Cycle Manager
Saudi German Hospital
Jeddah, Saudi Arabia
11.2020 - 01.2022
- Management of Pre-Authorization operation, follow up Approval Requests submitted to insurance companies and assure achievement of maximum Approvals in the accepted TAT.
- Management of Claims Submission, assuring Claims Submission in Due Dates with Accepted SLA.
- Monitoring the performance of Reconciliation unit and reviewing Closing % with the payers after reviewing denial reasons and replies of concerned unit.
- Reviewing contract status for each payer.
- Established NHPIES Mapping and NHPIES Activation as per CHI Regulation.
- Reviewing contract status for each payer.
- Established and monitored key performance indicators KPIs to assess operational effectiveness and drive decision-making.
Deputy Insurance Manager
Andalusia Group for Medical Services
Jeddah, Saudi Arabia
08.2020 - 11.2020
- Management of Approval operation, follow up Approval Requests sent to insurance companies and assure achievement of maximum TAT sending Approvals to the concerned insurance companies
- Management of Claims Submission, assuring Claims Submission in Due Dates with Accepted SLA.
- Management of Denials by Monitoring performance of Resubmission unit and ensure reply to all denials received from the payer.
- Reviewing contract status for each payer.
- Established NHPIES Mapping and NHPIES Activation as per CHI Regulation.
- Established and monitored key performance indicators KPIs to assess operational effectiveness and drive decision-making.
Medical Claims Section Head
Andalusia Group for Medical Services
Jeddah, Saudi Arabia
07.2019 - 08.2020
- Follow up the process related to Medical Claims Submission to ensure early flow of insurance companies (Payer)
- Review Jumbo Medical Claims with Claims supervisors before sending to the payer
- Review reports from Supervisors regarding flow rate from each payer and working on the issues related to decreased flow rate from any payer
- Monthly review reports about KPI of Claims Staff.
Medical Claims Section Head
Andalusia Group for Medical Services
Jeddah, Makkah Region
04.2019 - 08.2020
- Follow up the process related to Medical Claims Submission to ensure early flow of insurance companies (Payer) payment
- Review Jumbo Medical Claims with Claims supervisors before sending to the payer
- Review reports from Supervisors and Operation Managers regarding flow rate from each payer and working on the issues related to decreased flow rate from any payer
- Monthly review reports about KPI of Claims Staff.
Medical Claims Supervisor
Andalusia Group for Medical Services
Jeddah, Makkah Region
12.2017 - 10.2019
- Follow up the process related to Medical Claims Submission to ensure early flow of insurance companies (Payer) payment
- Review Jumbo Medical Claims with Claims Head before sending to the payer
- Review reports from Operation team regarding flow rate from each payer and working on the issues related to decreased flow rate from any payer
- Monthly review reports about KPI of Claims Staff.
Medical Claims Supervisor
Andalusia Group for Medical Services
Jeddah, Saudi Arabia
12.2017 - 10.2019
- Follow up the process related to Medical Claims Submission to ensure early flow of insurance companies (Payer)
- Review Jumbo Medical Claims with Claims supervisors before sending to the payer
- Review reports from Supervisors regarding flow rate from each payer and working on the issues related to decreased flow rate from any payer
- Monthly review reports about KPI of Claims Staff.
Senior Preauthorization and Quality Assurance Officer
Globemed Egypt
11.2016 - 04.2018
- Senior Approval Doctor and Quality Assurance : Approval for inpatient requests
- Auditing Approvals of other doctors and training Colleagues how to create an approval.
Senior Preauthorization and Quality Assurance Officer
Globemed Egypt
11.2016 - 04.2018
- Senior Approval Doctor and Quality Assurance
- Approval for inpatient requests
- Auditing Approvals of other doctors and training Colleagues how to create an approval.
Senior Preauthorization Officer
Med Right For Medical Services
Giza
01.2014 - 01.2016
- Approval inpatient and outpatient requests
- Responsible for training for the new Approval staff.
Senior Preauthorization Officer
Med Right For Medical Services
Giza
01.2014 - 01.2016
- Approval inpatient and outpatient requests
- Responsible for training for the new Approval staff.
Education
BSc - Medicine and Surgery
Ain Shams University
09.2005 - 06.2012
Skills
- Leadership Skills
- Negotiation
- Problem Solving
- Diplomatic communication
- Effective delegating
- Technical proficiency
- Profit and Loss Analysis
- Contract negotiation and administration
Certification
- Management Fundamentals
- The Economics of Health Care Delivery
- Operation Management Foundations
- NHPIES COD-02 FOR HCP
- NHPIES INT-01 FOR HCP
- NHPIES-MAP-01
- PTH-ADMINISTRATIVE REVENUE CYCLE MANAGEMENT
- PTH-MEDICAL MALPRACTICE INSURANCE
- PTH-VALUE BASED HEALTHCARE
Languages
Arabic - Native
English - Professional
Timeline
Senior Revenue Cycle Manager
Al-Abeer Medical Group
07.2025 - Current
Senior Revenue Cycle Manager
Comprehensive Family Medical Group
01.2022 - 07.2025
Revenue Cycle Manager
Saudi German Hospital
11.2020 - 01.2022
Deputy Insurance Manager
Andalusia Group for Medical Services
08.2020 - 11.2020
Medical Claims Section Head
Andalusia Group for Medical Services
07.2019 - 08.2020
Medical Claims Section Head
Andalusia Group for Medical Services
04.2019 - 08.2020
Medical Claims Supervisor
Andalusia Group for Medical Services
12.2017 - 10.2019
Medical Claims Supervisor
Andalusia Group for Medical Services
12.2017 - 10.2019
Senior Preauthorization and Quality Assurance Officer
Globemed Egypt
11.2016 - 04.2018
Senior Preauthorization and Quality Assurance Officer
Globemed Egypt
11.2016 - 04.2018
Senior Preauthorization Officer
Med Right For Medical Services
01.2014 - 01.2016
Senior Preauthorization Officer
Med Right For Medical Services
01.2014 - 01.2016
BSc - Medicine and Surgery
Ain Shams University
09.2005 - 06.2012