Mostafa Darwish
Riyadh,Saudi Arabia
Summary
A seasoned professional with over eight years of experience in claims processing and adjudication within the Saudi insurance sector. Demonstrates expertise in medical claims management, leveraging advanced skills in Excel and a comprehensive understanding of the Saudi Nphies platform. Proficient in issuing claim forms and possesses strong decision-making, problem-solving, attention to detail, and communication skills. Holds IFCE certification and is well-versed in medical insurance protocols. Committed to enhancing operational efficiency and accuracy in claims processing.
Overview
11
11
years of professional experience
3
3
years of post-secondary education
Work history
Claims adjuster
Globemed Saudi
Riyadh, Riyadh Region
10.2022 - Current
- Worked closely with other professionals such as medical professionals to understand the severity of damages or injuries associated with a particular claim.
- Maintained professionalism at all times even under stressful situations which sometimes arise due to disagreements over settlement amounts.
- Facilitated timely resolution of disputes through effective negotiation strategies.
- Reviewed policy details carefully to confirm coverage limits before proceeding with claims adjustment process.
- Handled all claims within established service level agreements.
- Ensured compliance with company policies whilst processing each claim.
- Employed strong analytical skills for detailed claim assessment.
Claims adjuster
Globemed Egypt
Cario, Egypt
01.2018 - 09.2022
Claims processing and adjustcation
Medivisa
Cairo, Egypt
01.2014 - 12.2017
Education
Bachelor of Law - Law
Faculty of Law, Cairo University
Cairo 09.2009 - 09.2012
Skills
- Claims processing and adjudication in Globemed Saudi & I have experience more than eight years in Saudi claims job
- I have a skill in dealing with Excel to process medical claims
- Knowledge of the Saudi Nphies platform
- Knowledge of Medical Insurance
- Claim form issuing
- During the course of my career, I have gained my decision making, problem solving, attention to detail and communication skills
- IFCE certified
Languages
Arabic
Native
English
Intermediate
Affiliations
- Exercising, especially weight lifting, walking a lot, and sometimes reading
Timeline
Claims adjuster
Globemed Saudi
10.2022 - Current
Claims adjuster
Globemed Egypt
01.2018 - 09.2022
Claims processing and adjustcation
Medivisa
01.2014 - 12.2017
Bachelor of Law - Law
Faculty of Law, Cairo University
09.2009 - 09.2012
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