MOHAMMAD QURESHI
Dammam,Saudi Arabia
Summary
Experienced professional with a strong background in regulatory Compliance, particularly CCHI regulations and Saudi health insurance laws. Adept at policy management, including the design, implementation, and oversight of group and individual medical policies. Proven expertise in claims processing, encompassing submission, verification, auditing, and reimbursement management. Skilled in administrative coordination through effective documentation, reporting, and communication. Demonstrates exceptional customer service by professionally handling inquiries, complaints, and policy clarifications. Strong team leadership abilities with a track record of training, mentoring, and supervising administrative teams.
Overview
27
27
years of professional experience
1
1
Certification
Work history
Medical Executive
Al Abdulkarim Holding Co.
Dammam
05.2019 - 11.2025
- Managed medical operations for a large medical insurance portfolio with full CCHI compliance.
- Coordinated among insurance providers, TPA, hospitals, and clients to streamline policy and claims processes.
- Maintained detailed records of policies, endorsements, claims, and member data.
- Achieved increased customer satisfaction with focused marketing campaigns.
Medical Insurance Head
Al Abdulkarim Holding Co.
Dammam
10.2015 - 05.2019
- Oversaw group medical insurance operations for all employees.
- Ensured full alignment with CCHI rules, documentation, and policy renewals.
- Coordinated with healthcare providers to handle claims, approvals, and billing issues.
- Monitored policy performance and recommended improvements to management.
Insurance Administrator
Al Abdulkarim Holding Co.
Dammam
09.2005 - 05.2015
- Assisted in developing and implementing health insurance policies as per CCHI guidelines.
- Processed, verified, and followed up on claims to ensure timely settlement.
- Prepared regular reports and insurance-related documentation for senior management.
- Collaborated with hospitals and clinics to streamline claims inquiries and approvals.
- Provided clear guidance to clients regarding benefits, coverage, and policy terms.
General Nurse
AKH Clinic
12.1998 - 05.2005
Education
Diploma - General Nursing – Specialty in Operation Theatre (OT)
Skills
- Regulatory Compliance: Strong knowledge of CCHI regulations and Saudi health insurance laws
- Policy Management: Designing, implementing, and managing group and individual medical policies
- Claims Processing: Submission, verification, auditing, and reimbursement management
- Administrative Coordination: Documentation, reporting, and communication
- Customer Service: Professional handling of inquiries, complaints, and policy clarifications
- Team Leadership: Training, mentoring, and supervising administrative teams
Certification
SCFHS License – 06-K-N-31000
Languages
Arabic: Native / Professional Proficiency
English: Fluent
Accomplishments
- Successfully implemented a new claim processing system
- Led an administrative team to achieve 100% CCHI compliance.
Timeline
Medical Executive
Al Abdulkarim Holding Co.
05.2019 - 11.2025
Medical Insurance Head
Al Abdulkarim Holding Co.
10.2015 - 05.2019
Insurance Administrator
Al Abdulkarim Holding Co.
09.2005 - 05.2015
General Nurse
AKH Clinic
12.1998 - 05.2005