Sobhy Mohamed Farid
Riyadh,Saudi Arabia
Summary
Accomplished professional with expertise in Revenue Cycle Management, AR-DRG Coding & Reimbursement, and NPHIES Digital Platform & CHI Compliance. Demonstrates proficiency in Payer Contracting, Strategic Negotiations, and Denial Prevention through effective Root Cause Analysis. Skilled in ICD-10 Coding, Medical Auditing, and AR-DRG Case Mix Optimization. Adept at Financial Analysis, Revenue Forecasting, and Policy Development with a focus on Compliance Governance. Strong strategic planning abilities complemented by exceptional communication, negotiation, and stakeholder management skills. Committed to ethical conduct and performance metrics evaluation while inspiring motivation through influential communication.
Overview
18
18
years of professional experience
1
1
Certification
Work history
Head of RCM / Business Center Manager
Hayat National Hospitals
2021.09 - 2025.12
- Lead end-to-end revenue cycle operations including preauthorization, coding, billing, claims submission, denials management, and payer reconciliation.
- Achieved 96% claim acceptance rate and reduced denial volume by over 40% through process redesign and physician documentation improvement.
- Played a key role in NPHIES implementation and ensured full compliance with CHI regulations and national digital health requirements.
- Developed KPI dashboards for executive leadership covering revenue leakage, turnaround time, and payer performance.
- Led high-level negotiations with insurance companies resulting in improved contract terms and measurable revenue growth.
Business Center Manager
Al Shifaa Al Kamel Medical Complex
2017.01 - 2021.01
- Managed medical insurance operations, pre-authorizations, and claims auditing.
- Supervised ICD-10 coding accuracy and optimized documentation quality.
- Reduced claim rejections through structured medical audit and payer alignment.
Business Center Manager
Healthy Vision Medical Complex
2015.01 - 2017.01
- Oversaw medical insurance department operations and claims submission workflows.
- Implemented internal audit controls to minimize billing errors and rejections.
Pharmacy Manager & Medical Insurance Supervisor
Al-Naim Medical Complex
2008.01 - 2015.01
- Managed pharmacy operations alongside medical insurance supervision.
- Conducted medical claims audits and coordinated with insurance providers.
Education
Bachelor of Pharmacy - Honors
Al-Azhar University
Skills
- Revenue Cycle Management (RCM)
- AR-DRG Coding & Reimbursement
- NPHIES Digital Platform & CHI Compliance
- Payer Contracting & Strategic Negotiations
- Denial Prevention & Root Cause Analysis
- ICD-10 Coding & Medical Auditing
- AR-DRG Case Mix Optimization
- Financial Analysis & Revenue Forecasting
- Policy Development & Compliance Governance
- Strategic Planning & Problem Solving
- Communication
- Negotiation
- Stakeholder Management
- Effective delegating
- Interpersonal effectiveness
- Inspiring motivation
- Influential communication
- Diplomatic communication
- Performance metrics evaluation
- Ethical conduct
- Strategic planning software
Certification
- Marketing Strategy Fundamentals (SCMS-F), SMstudy, 09/25
- Mini Master of Hospital Management, American Board of Professional Studies (ABPS), USA, 08/25, Duration: 60 Hours | Grade: Excellent
- AR-DRG: From Coding to Reimbursement, Innovative Training Academy, 10/25, Advanced application of AR-DRG in Saudi healthcare aligned with Vision 2030 | CPD: 2 Hours
Personal Information
Title: RCM Director | Healthcare Revenue Cycle & Insurance Operations Leader
Custom
Available upon request.
Languages
English
Advanced
Arabic
Native
Timeline
Head of RCM / Business Center Manager
Hayat National Hospitals
2021.09 - 2025.12
Business Center Manager
Al Shifaa Al Kamel Medical Complex
2017.01 - 2021.01
Business Center Manager
Healthy Vision Medical Complex
2015.01 - 2017.01
Pharmacy Manager & Medical Insurance Supervisor
Al-Naim Medical Complex
2008.01 - 2015.01
Bachelor of Pharmacy - Honors
Al-Azhar University