NESMA MOHAMED HANY HUSSEIN

RCM Manager

Selat for Business Solutions Co. (at Prince Sultan Military Medical City)

October 2019 – Present

Designed and implemented a streamlined billing system, reducing data entry errors by 15% and accelerating revenue cycle processing by 20%.
Directed revenue cycle operations, overseeing account management, insurance negotiations, collections, cash posting, and contract analysis, ensuring compliance and operational efficiency.
Led a team of 10 staff, conducting performance evaluations, providing actionable feedback, and facilitating one-on-one coaching, resulting in a 25% increase in team productivity.
Evaluated financial hardship applications and resolved 90% of patient billing complaints within 48 hours, enhancing patient satisfaction and trust.
Spearheaded recruitment, onboarding, and training initiatives, optimizing department workflows and improving staff retention by 50%.
Managed medical approvals for inpatient, outpatient, and surgical services, responding to insurance queries promptly and achieving a 95% approval rate.
Oversaw hospital admission office operations, coordinating with patients for surgeries, critical cases, and emergencies, ensuring seamless service delivery.

• Prepared and submitted medical bills for hospital departments, generating financial claims for insurance companies and achieving high reimbursement rates.
• Reviewed insurance contracts, requested and integrated new service codes into hospital systems to enhance billing accuracy.
• Issued and followed up on medical approvals for clinics, operations, and outpatient services, addressing insurance notes promptly.

• Monitored insurance approvals in hospitals, submitted daily reports on outpatient and admission cases, and facilitated surgical approvals.
• Assisted patients in completing required medical services, ensuring full satisfaction and compliance with company protocols.

• Requested medical approvals for center services, prepared insurance claims, and reconciled account balances for timely collections.
• Handled financial settlements and recovered outstanding claims, contributing to improved cash flow.

• Coordinated medical approvals and patient relationships, assisting with admission office operations.
• Ensured seamless service delivery by managing approvals for hospital-provided medical services.

• Requested and processed medical approvals for provided services, enhancing operational efficiency.

• Supported physiotherapy, laser liposuction, and nutrition services, assisting doctors in patient care.