MOHAMED MATAR

Followed up on denied insurance claims, identifying technical or medical reasons for inpatient cases.

• Coordinated with insurance approval doctors and engaged in meetings to address feedback.
• Implemented new insurance policies and guidelines within hospital systems.
• Conducted regular meetings with doctors to update on health insurance changes and hospital policies.

• Managed all aspects of revenue cycle operations, ensuring optimal flow from pre-registration to payment.
• Conducted cost estimates per established guidelines to maintain financial accuracy.
• Established policies aimed at improving reimbursement rates and reducing errors in operations.
• Reviewed cases for documentation completeness before submission to payers.
• Engaged with payers/third-party administrators regarding approval queries.
• Maintained compliance with billing and coding standards, adhering to regulatory guidelines.
• Collaborated with healthcare staff to clarify claims for preapproval eligibility.

Analyzed issues systematically, taking decisive action for resolution.

• Company Overview: United Arab Emirates
• United Arab Emirates

• Company Overview: Khartoum
• Managing the medical pre authorization claim for out patient and in patient admissions.
• Make sure that all Medical data written by physician.
• Handless customer service medical assistance from provider members and insurance payers.
• Monitoring turnaround time (Tat) for approval.
• Verpal pre approval for IP admission.
• Khartoum

• Company Overview: Khartoum
• Review patient records, examining the proposed treatment plans and associated costs.
• Work with patients to help them understand their insurance coverage and answer any related queries they might have.
• Keep detailed records of all interactions with patients and insurance companies.
• Collaborate with medical professionals to understand the necessity of certain treatments and advocate for patient care with insurance companies.
• Responding to hospital inquiries to clarify the reasons for rejection of requests.
• Khartoum

• Company Overview: Khartoum
• Escalate the process claim with insurance policy and conditions.
• Ensure that target are met for department turnaround time quality.
• Reviewing Medical records and other documents related to the health care policy services.
• Ensure that all information is accurate, complete with standard and regulation.
• Providing feedback or recommendations on quality of care.
• Reviewing claim from health insurance company.
• Follow medical audit operations procedures insurance policy regulator guidelines policy on fraud and abuse.
• Khartoum

• Company Overview: Khartoum
• Treatment all cases in emergency department for both medicine cases and surgery.
• Khartoum