Ansam Hassan Md Email & Phone Number

Dubai, United Arab Emirates

• Provide expert clinical guidance for severe cases using international best practices to ensure patients receive gold-standard treatment.• Investigate and address complex medical authorization and high-value claims inquiries from various stakeholders in accordance with Bupa Global's policies.• Ensure accurate interpretation and processing of policy and rule codes, in line with customer service standards.• Facilitate communication between various business units to support the resolution of inquiries, including those related to claims eligibility, coverage, and alternative treatment options.• Work in identifying and investigating potential fraud or abuse cases, preparing reports, and providing second opinion services.• Comply with local regulatory requirements and investigate customer complaints to provide effective solutions.• Facilitate home nursing referrals and monitored their performance.• Prepare monthly reports for review and execution of action plans, and worked with brokers, sales teams, and HR for cases not covered by insurance.• Collaborate with the clinical governance team to maintain and improve the quality of patient care.

Dubai, United Arab Emirates

• Deliver high-level support to members who are commencing or in the process of receiving health treatment for a variety of medical diagnoses and therapies. • Examine and handle clinical objections in line with the established policies and procedures, and ensure the team understands the outcomes of these complaints.• Review and implement current and newly established policies and procedures.•Evaluate medical ICD and CPT codes to ensure accurate payments and Collaborate with the network team to negotiate codes with the providers.• Conduct Concurrent audit. • Coordinate workflow while meeting deadlines and suggesting and improving enhancement of services.• Conduct retrospective audits, closely supervise service providers, maintain team vigilance on the suspect cases, and promptly report any questionable findings through the appropriate channels and procedures.• Conduct training for new and existing staff, execute performance evaluations, and fulfill other employee management and development needs.

Khartoum, Khartoum State, Sudan

• Emergency Room (ER) triage and assessment• Advanced life support and resuscitation procedures• Rapid diagnosis and treatment of acute conditions• Crisis management and disaster response planning• Management of critically ill patients and their families in intensive care units (ICUs)• Monitoring of patients' vital signs, lab results, and response to treatment• Assisted in surgical procedures, pre-and post-operative patient care, and wound management.• Conducted pre-operative patient assessments, preparing them for surgery and educating them about post-operative care.• Communicated with patients and their families to provide updates and address concerns.• Applying gold-standard guidelines in assessing, diagnosing, and treating patients • Participated in interdisciplinary teams to continuously improve the quality of patient care• Assisted in the delivery of neonates through various modes of delivery including NVD and LSCS.• Assessed and managed acute and chronic illnesses in children, including conducting physical exams and ordering and interpreting diagnostic tests.

Master'S Degree, Public Health

As a student in this program, I have the opportunity to gain a comprehensive understanding of public health and its challenges, both.

Bachelor Of Medicine, Bachelor Of Surgery (Mbbs), Medicine