Mayada Hussein Email & Phone Number

Dubai, Ae

United Arab Emirates

United Arab Emirates

United Arab Emirates

United Arab Emirates

• Overseeing performance of onsite staff ensuring punctuality and no extracurricular activities on the ground in all on- site operation areas• Ensures processing of all claims existing in client HIS and creation of encounters in the system• Meet the onsite operation KPIs• Ensures staff compliance on implementing internal procedures• Carry out random checks on IP coding and approval coding• Ensures capturing of all IP services especially complex and high cost cases• Ensure communication to respective doctors all medical necessity related denials and prepare effective plans to prevent such denials in future• Ensure communication of audit team findings and insurance companies and TPAs denials and rejections to the concerned persons within onsite operation and hospital and follow up on trend and ensure improvement• Communicate to IRM pricing and payer related issue• Supervisor allocation of work load to on site operation staff• Design process flows, SOPS and on-site operation manual• Liaise with hospital RCM director for day to day escalations from both teams.• Ensure timely bulk imports for non-insurance claims• Liaise with rules engine team for rules creation as and when required• Design forms required by the onsite operation ex. cost estimate• Conduct UAT for any development done by IT• Provide technical support to on site operation staff• Prepare periodic reports as assigned by project director• Support back office departments and personnel.• Provide and attend necessary training as necessary• Investigate, evaluate and resolve day to day issues and escalations on the ground and ensures preventive measures are in place• Liaise with back office on daily basis for submission dependencies ensuring timely provision of all back-office requirements• Ensures timing resolution of back office coding audit finding• Ensures that one to one preventive meetings are held with doctors based on back office audit and rejection analysis team findings.

United Arab Emirates

Perform and supervise all underwriting procedures and processes within set KPI’s• Analyze new and renewal schemes (risk profile, census, claims experience, existing benefits, benefits deviations etc…)• Support relationship managers and subordinates to achieve business targets• Monitor and control schemes performance (Technical reports, utilization reports, itemized reports etc….)• Provide monthly reports for materialized business & renewal retention through various business sources• Apply necessary procedures to monitor quote compliance with DHA/HAAD regulations• Periodic review of pricing module with suggested amendments•Coordinating with the re-insurers for non-standard cases. •Monitor new & renew policies issuance and all related tasks.•Interaction with brokers for the purpose of building and strengthening relations

Cairo, Egypt

United Arab Emirates

*Develops and promotes high standard of customer care service and increases staff awareness to exceed patient’s expectations. *Implements customer service activities that contribute to exceeding patients expectations. *Handles and resolves patient complaints and rewards for patient compliments.*Develops, maintains and monitors Customer Compliment and Complaint Management Process System.*Facilitates solutions to patient problems directly or through other department/parties which may include reassignment of customer relations staff accordingly.*Implements continuous quality improvement activities:*Determines customer service requirements by maintaining contact with patients; visiting operational environments within the hospital; conducting surveys; benchmarking best practices; analyzing information and applications.*Ensures employees are highly trained in quality improvement and understand their contributions towar*Executes discipline at all levels to deliver continuous service improvement.*Manages all socially related work of patients when required, in collaboration with the social work department when appropriate. *Mediates and problem solves for inter-/intra-departmental issues. Facilitates interdepartmental communication, negotiation and decision-making. *Documents and communicates relevant information, actions and decisions to the Hospital Administrator. *Collaborates with clinical and support staff to deliver high quality customer service care on a 24-hour basis. *Ensures compliance with the JCI & ISO requirements amongst staff..*Demonstrates ability to see the big picture in terms of the strategic operational plan and ability to monitor and direct processes to fulfill such plans.*Maintains confidentiality regarding patient information and regarding administrative matters of confidential nature.*Develops and promotes a fair administrative environment which is unbiased and apolitical.

Cairo

Direct relationship with customer (visit, work-in-progress review, needs analysis, escalation) Organize and attend to Knowledge Sharing sessions (customer business and solutions) and contribute with external campaign (market, competition, customers). Internal Staff meeting preparation, follow-up (project, incident reports, malfunction status...) and reporting Have a detailed understanding of how CRM databases work, and be able to use them strategically to deliver business value.Understands the process in the hospital and support better guest experience through make recommendations for improvements as appropriate.Communicate with guest effectively, especially in advanced problems in a pleasant and persuasive manner to give comfort to guest while he/she deals with them.Assist the staff in categorizing problems and discuss their point of views in this regard. Work closely with non-patient support teams (Finance, Legal, Security, etc) when handling guest complains.Provide root-cause analysis and recommendations to improve the service given by Hospital and support processes.Supervise subordinates while performing their assigned duties in order to evaluate and improve their skills. Deliver the departmental orientation for the new comersShare in delivering the orientation for nursing staff regarding the most common complaint, in order to minimize the numbers of complaints.Develop all the related policies and procedures [Patient and Family Rights] as required to meet the JCI standard.

Egypt

Assessing background information on the clientStudying insurance proposals & Calculating the riskDeciding how much should be paid outLiaising with professionals and specialists to help judge risk assessmentSelecting appropriate and competitive premiums based on information and judgmentWriting policies and adding specific conditions when requiredDeciding whether the risk should be shared with a re-insurerNegotiating termsSupervising the benefits & conditions building for each policy in the TPA system Supervising the addition and deletions & billing clientsCommunicate with the payers providing them the required reports for their clients

Cairo, Egypt

Handle internal and external complaintsAssist in prioritizing, collaborating internally and facilitation resolution casesProvides feedback in regards to Customer Satisfaction and Overall performance of client servicesAnalyze internal work process flows to improve servicesCreate and Implement new procedures/technologies based on patterns of complaintsWorks in collaboration with all departments to improve overall quality of customer relationsVisits clients as needed for complaints and to maintain solid client relationsResponsible for providing executive support to corporate business development activities as directedWork closely with the Call Centre relating to escalating cases, by providing them supportConduct random audits on inbound/outbound calls to monitor level of Customer ServiceWork with the Business Analyst to improve our IT Solutions and create new functionsOther related activities determined by Executive Management

Cairo, Cairo, Egypt

Supervising customer service representatives on approvals, suspended claims, answering phone calls and handling customer objections for all contracted companies with DMS.Regular training sessions to the team players for customer ordination - explain the benefits& the exclusions for the new policies.Escalating weekly and monthly reports evaluating my team membersCustomer orientation visits to the new contracted companies in order to explain how they can avail the medical services.Account manager for most important clients. Following up our service providers to maintain a superior relationship in order to improve our service quality and customer satisfaction.

 Receiving orders form our head quarter (Italy) Release them to production Department &follow up the production to meet the deadline. Issue invoices to our clients all over the world Handle all the correspondences with our customers &providers Issue weekly report and send it to head office "Italy" Issue Monthly report and send it to head office "Italy"

Receiving calls to our customers Receiving customer ordersReceiving all customers inquiriesArrange & attend the outdoor events to represent the company & sell the company products.

Cii Certified, Insurance

Good, Professional Diploma Medical Insurance, A

Bachelor Of Applied Science (B.A.Sc.), Food Science, Good

Mini Mba- Operations Management, A

Operations Management consists of: -Operations Planning and Design -Operations Management -Managerial Decision Making -Project management.

A+, Super User Program, A+

Small Business. Office Administrator & Interpersonal skills.

A, Business Administration, Management And Operations, A

Activities and Societies: Basic Business Skills Acquisition (BBSA) I Sponsored by the Future Generation Foundation (FGF) I Cairo I Egypt.

Medical Insurance Coding Specialist/Coder

Medical Insurance Coding Specialist/Coder