Shameel Kurumbathodi
Pharmacist, Healthcare Data Analyst
Jeddah
Summary
Experienced Healthcare professional with advanced skill of medical data analysis and cost utilization studies. Actively participated in various digitalization of medical claims process in medical insurance and engaged in process making daily reports for monitoring business KPIs and targets. Seeking for suitable positions in healthcare insurance, Pharmacy, clinical research, pharmacovigilance and pharmaceutical research industries.
Overview
10
10
years of professional experience
6
6
years of post-secondary education
Work History
Supervisor, Medical claims operation
Bupa Arabia
09.2021 - Current
- Claims planning, data analysis, adjudication, monitoring KPIs and maintain targets
- Guided and supervised team based on many projects and handled team to make optimum results
- Analyzing ICD codes and providing various reports to concern cells in organisation
- Actively participating in creating and implementing improvements to achieve KPI, Production, and results
- Enrolled in outpatient claims auditing and supervised as team lead for provider data abuse and overbilling trends escalations
- Always interested in adapting new innovations, and actively participated medical claims automation process applied by data science for dental-optical claims and updating medical codes.
Senior Officer, Medical claims operation
Bupa Arabia
09.2013 - 08.2021
- Claims planning, distribution and preparing production reports and monitoring batch updates
- Claims adjudication, analyzing fraud and providing medical decision based on policies and rules
- Participated internal medical audit process
- Actively engaged various training process and guided team in automation.
Pharmacist
KM Medical centre
- 07.2010
- As a pharmacist, dispensing of medicines based on prescriptions, and providing patient counselling and drug information
- Achieved well controlled inventory system Continually evaluates quality and safety performance, identifies improvement opportunities and plans improvement programmes
- Provides safety, comfort care, and treatment of patients according to established legal, ethical, and institutional standards.
Education
Master’s in pharmacy -
SRM University Chennai-India
08.2010 - 05.2012
Bachelor of Pharmacy - undefined
University of Calicut Kerala-India
07.2005 - 05.2009
Skills
Microsoft Officeundefined
Awards Or Certifications
- Communicating for Impact, McKinsey & Company, 05/2022
- IFCE (Insurance foundation certificate examination), The Financial Academy, 05/2022
- SCHS (Saudi council for Health specialities), Accreditation, Saudi Arabia
Languages And Interests
English, Hindi, Volunteered in seminar Emerging trends in pharmacy practice held in university.
References
- Dr. Musaab Younis, Epidemiologist at Public Health Agency of Canada, musaab_yahia@yahoo.com
- Dr. Bilal Nawaz, Sr. Manager -Medical claims operation, Bupa Arabia, Jeddah KSA, bilalnavaz@hotmail.com
Timeline
Supervisor, Medical claims operation
Bupa Arabia
09.2021 - Current
Senior Officer, Medical claims operation
Bupa Arabia
09.2013 - 08.2021
Master’s in pharmacy -
SRM University Chennai-India
08.2010 - 05.2012
Bachelor of Pharmacy - undefined
University of Calicut Kerala-India
07.2005 - 05.2009
Pharmacist
KM Medical centre
- 07.2010
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