Mohammed Alammar Email & Phone Number

Riyadh, Saudi Arabia

● Negotiating potential clients and studying the feasibility and benefits of proposed projects.● Planning and scheduling of projects, projects executing and projects deliverables.● Ensuring the company’s quality of services to meet the company’s vision, mission, and values.● Identifying and solving problems that arise in the company's projects operations.● Screening potential candidates, hiring, training, developing staff.● Studying and analyzing data and reports to ensure the best course of action and influence critical decisions.● Managing communications with internal and external stakeholders for all company’s projects.Achievements:− Successfully leading and completing the MIP’s largest project, by achieving the client’s requirements and deliverables on scheduled time-frame.− Completing a full operation cycle Gap Analysis & Risk Assessment project for a leading healthcare provider in sports medicine, in addition to drafting a turnaround plan and consultation session to monitor progress.− Provide regular development & counseling sessions for a healthcare IT solutions provider to implement advanced features and functionalities to their solutions and achieve desired milestones.

Riyadh, Saudi Arabia

● Managing & maintaining relationships with with governmental service providers in all regions.● Monitoring service providers performance and claim quality.● Analyzing reports to determine providers KPIs.● Oversees governmental service provider compliance.● Negotiating clearance process & reconciliation with service providers.Achievements:- Enhancement of workflow process to facilitate service providers insurance cycle.- Managing to achieve around 4 Million in savings.

Al-Riyadh Governorate, Saudi Arabia

● Planning & managing RCM sub-units’ workflow, activities, and productivity.● Studying & analyzing revenue reports to identify loss of revenue and business growth.● Partaking in communicating & negotiating insurance companies’ new contracts.● Monitoring monthly credit denial reports and reconciliation settlements.● Responsible for implement RCM department, business development & marketing strategies. ● Representing RCM department in cross-departmental meetings and external communication.● Developing & overseeing workflow enhancements implementation.● Setting team KPIs and monitor their performance against it.

Riyadh, Saudi Arabia

● Training newly hired stakeholders on insurance Rules & Regulations.● Auditing & reviewing invoicing system (HIS) with IT department to ensure correct data records.● Responsible to set up HIS key controls to ensure accurate & secured end-users’ data entry for insurance patients.● Setting the teams goals, train, support, and lead them to meet objectives.● Addressing patients’ issues and solve their complaints.● Developing official documents to ensure meeting rules, regulations, and best practice.

Al-Riyadh Governorate, Saudi Arabia

Responsibilities include:-Setting periodic goals and key performance metrics for the team-Training, coaching, and managing a team of claims officers to meet the goals and KPIs set by the team and department to close all medical claims while maintaining quality control. -Trained newly hired claims officers to document, review, audit, sort, and close medical claims in a timely manner. Additionally trained them to cross check and reference claims for fraud prevention.

Al-Riyadh Governorate, Saudi Arabia

Nominated and awarded Top Claims Officer for June 2019Responsibilities included: -Maintaining frequent telephone contact with clients, gathering facts necessary to determine if claims can be approved or denied, including inspecting client- and hospital-provided documentation-Studying policy provisions, reviewing documentation, and determining course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss.-Conducting thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability status, and damages that are applicable for each claim.-Reviewing and auditing all claims to ensure legal compliance, as well as refer information ascertained during claims investigation or audit to legal support for settlement action-Cross checking and referencing claims to prevent fraud abuse and waste-Refers information from claims investigations to other company departments for possible guidance in policy making.

Riyadh, Saudi Arabia

● Evaluating patients’ condition and determine proper treatment plan.● Creating multi-phase treatment plan.● Contracted with multiple physiotherapy clinics to follow-up their patients home exercise plans.