Khalid AL Saghir
Medical Claims Reconcilitions
Riyadh,01
Summary
Experienced Medical claims reconciliation with over 10 years of experience in insurance. Excellent reputation for resolving all payments issues improving customer satisfaction.
Overview
4
4
years of post-secondary education
8
8
years of professional experience
Work History
Medical Representative
Medical Claims Reconciliation
RIYADH-AXA INSURANCE COMPANY, RIYADH-AXA INASURANCE COMPANY
08.2015 - Current
- Arranged appointments with doctors, pharmacists and medical teams to raise awareness how preparing the claims .
- Analyzed market to identify new opportunities and strengthen relationships with hospitals, medical centers and primary provider physicians.
- Followed up on potentially fraudulent claims initiated by provider's.
Managed large volume of medical claims on daily basis. - Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Reviewed outstanding payments and settle complete with Providers
Medical Claims Processor
Medical Claims Processor
RIYADH-SAUDI ARABIAN INSURANCE COMPANY (SAICO), RIYADH-SAUDI ARABIAN INSURANCE COMPANY (SAICO)
01.2011 - 06.2013
- Managed large volume of medical claims on daily basis.
- Reviewed provider coding information to report services and verify correctness.
- Evaluated accuracy and quality of data entered into agency management system.
- Reported policy changes and company conditions affecting customer satisfaction.
- Tracked all pending authorizations to resolve discrepancies and avoid any different on claims amount .
- Maintained confidentiality of patient finances, records and health statuses..
Education
Bachelor of Science - Biochemistry
King Saud University
RIYADH 09.2005 - 01.2010
Insurance Certificate - IFCE CERTIFICATE
Saudi Banking Institute
RIYADHInternational Classification of Diseases, ICD-10 - International Classification of Diseases, ICD-10 C
Saudi Banking Institute
ICDL -4 - ICDL -4
AL JAZEERA ACADMIC
RIYADHSkills
Customer Relations
undefinedTimeline
Medical Representative
Medical Claims Reconciliation
08.2015 - Current
Medical Claims Processor
Medical Claims Processor
01.2011 - 06.2013
Bachelor of Science - Biochemistry
King Saud University
09.2005 - 01.2010
ICDL -4 - ICDL -4
AL JAZEERA ACADMIC
International Classification of Diseases, ICD-10 - International Classification of Diseases, ICD-10 C
Saudi Banking Institute
Insurance Certificate - IFCE CERTIFICATE
Saudi Banking Institute
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