Mohamed Ghazy
RIYADH,KSA
Summary
Over 11 years of experience in the medical insurance field in Saudi Arabia, working with insurance companies and healthcare providers, with comprehensive knowledge of claims processing, contract management, collection and reconciliations.
Dynamic professional with a strong foundation in problem-solving and communication skills, adept at maintaining composure under pressure. Expertise in public relations enhances the ability to effectively manage and communicate with diverse audiences. Committed to leveraging these skills to drive organizational success and foster positive relationships.
Overview
17
17
years of professional experience
Work history
RCM COLLECTION AND RECONCILIATION
WASEEL COMPANY
RIYADH, KSA
10.2023 - Current
- Carried out day-to-day duties accurately and efficiently.
- Quickly learned and applied new skills to daily tasks, improving efficiency and productivity.
- Successfully delivered on tasks within tight deadlines.
- Increased customer satisfaction by resolving issues.
- Completed customer orders with speed and accuracy.
- Gathered, recorded, and processed information accurately and efficiently for reliable claim management. Built positive relationships with customers and colleagues for enhanced service provisions.
- Effective medical claims and Accounts supervision with a strong background and many years of experience in medical claims and a full cycle of claims operation, including TPA & RCM experience.
- Driven performer capable of effectively handling multiple administrative tasks. Exemplary worker with highly developed investigative skills managing claims accounts with providers.
- - Responsible team player with a strong ability to reconcile accounts with all stakeholder groups in a timely manner. A bilingual individual with a proven track record of professionalism in handling provider accounts and extensive experience in medical claims.
Medical network accounts supervisor
ARABIAN SHIELD COOPERATIVE INSURANCE COMPANY
RIYADH, SUADI ARABI
05.2012 - 12.2020
- Managed payments by handling accounting records, informing providers of payment details, and generating documentation.
- Maintained regular interaction with the finance team to ensure timely payment flow to stakeholders.
- Oversaw claim processing, including direct submissions, resubmissions, endorsements, and recoveries.
- Conducted batch auditing by reviewing closed batches and issuing payment orders.
- Tracked and monitored provider payments to ensure compliance with prompt payment agreements.
- Facilitated reconciliation by following up with providers and conducting meetings to negotiate payments.
- Optimised help desk operations by tracking provider relations and resolving queries efficiently.
- Drafted contracts for new providers, negotiating discounts and establishing price lists.
- · TPA (Monitoring TPA operation for two and half years)
Retail sales representative
Procter and Gamble Company
ALEXANDRIA, EGYPT
02.2010 - 12.2011
- Delivered prompt service to optimise customer experience.
- Managed cash register, ensuring accuracy in transactions.
- Resolved customer complaints, promoting a positive brand image.
- Ensured neatness of merchandise displays for appealing visual aesthetics.
Administrative and accountant
Engineering Group for Contracting
ALEXANDRIA, EGYPT
06.2008 - 01.2010
- Streamlined budgeting exercises for efficient financial planning.
- Performed thorough expenditure tracking, preventing overspending.
- Assisted with strategic planning efforts leading to sustained growth.
Education
Commercial Technical Institute (2010)
EGYPT /2010 -
(IFCE) Certified in Insurance Fundamentals
RIYADH,KSA /2013 -
Certified Anti-Money Laundering (AML) Specialist.
/2016 -
Workshop - Power Up Your Influence.
/2024 -
Skills
- Problem-solving
- Calm under pressure
- Communication skills
- Public Relations
Timeline
RCM COLLECTION AND RECONCILIATION
WASEEL COMPANY
10.2023 - Current
Medical network accounts supervisor
ARABIAN SHIELD COOPERATIVE INSURANCE COMPANY
05.2012 - 12.2020
Retail sales representative
Procter and Gamble Company
02.2010 - 12.2011
Administrative and accountant
Engineering Group for Contracting
06.2008 - 01.2010
Commercial Technical Institute (2010)
/2010 -
(IFCE) Certified in Insurance Fundamentals
/2013 -
Certified Anti-Money Laundering (AML) Specialist.
/2016 -
Workshop - Power Up Your Influence.
/2024 -
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