Roqayah Albasri
Risk Management And Internal Audit
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
9
9
years of professional experience
7
7
years of post-secondary education
2
2
Languages
Work History
Assistant of risk, audit manger
01.2020 - Current
- Objectively review an organization'sbusiness processes by working on internalauditing for many department by extractingdata from oracle and work on excelformulas to make the KPI report
- Total care company (TPA)
- Manage the interaction between Hospitals and
- Insurance Companies for paymentinquires and resolve any payment disputes
- Support other functions in translating medicalreports to English
Administrator supervisor
Total Care Company
Alkhobar
2017 - 2019
- Collaborated with team members to achieve target results.
- Learned new skills and applied to daily tasks to improve efficiency and productivity.
- Conducted research, gathered information from multiple sources and presented results.
- Identified issues, analyzed information and provided solutions to problems.
- Prepared variety of different written communications, reports and documents.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Exceeded goals through effective task prioritization and great work ethic.
- Increased customer satisfaction by resolving issues.
- Resolved conflicts and negotiated mutually beneficial agreements between parties.
- Offered friendly and efficient service to customers, handled challenging situations with ease.
- Worked with customers to understand needs and provide excellent service.
Medical Claims Processor
total care company
khobar, saudi arabia
06.2013 - 06.2017
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Evaluated and settled complex insurance claims in strict timeframes.
- Managed large volume of medical claims on daily basis.
- Reviewed provider coding information to report services and verify correctness.
- Paid or denied medical claims based upon established claims processing criteria.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Maintained confidentiality of patient finances, records and health statuses.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Checked documentation for accuracy and validity on updated systems.
Education
Bachelor of Business Administration -
Imam Abdulrahman Bin Faisal University
Alkhobar 08.2015 - 05.2019
Health Insurance Diploma - Health Insurance
Al-Mana Health Institute
Alkhobar 09.2010 - 06.2013
Skills
Internal audit procedures
Additional Information
❖ project management and other tools for career development -
University of california,irvine
❖ Certified compliance officer GGC prep course - IBS training academy
❖ Certified compliance professional - the financial academy
❖ Certified internal auditor - financial training center
❖ Anti-money laundering and terrorist financing course -
Technical and vocational training corporation
❖ IFCE - Saudi Arabian Monetary Agency
Quote
The way to get started is to quit talking and begin doing.
Walt Disney
Timeline
Assistant of risk, audit manger
01.2020 - Current
Administrator supervisor
Total Care Company
2017 - 2019
Bachelor of Business Administration -
Imam Abdulrahman Bin Faisal University
08.2015 - 05.2019
Medical Claims Processor
total care company
06.2013 - 06.2017
Health Insurance Diploma - Health Insurance
Al-Mana Health Institute
09.2010 - 06.2013
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