Worked in approval section and supervising a 9 member team for In and Out Patient approvals.Monitoring of sending approvals for all active insurance companies for maintaining In and Out patient approvals including Elective cases, Urgent Operational procedures, Nursery, LND, ICU, NICU and new Admissions.Maintaining approvals records on daily basis arrives from all active insurance companies according to the requested services for approval and handover to related department, and copy to patients upon request.Very well experience and knowledge of using the online insurance approvals system (Waseel) and out of Waseel system Web sites for various Insurance companies including Bupa Arabia, Globemed Saudi, Gulfunion, Saudi Next care and Mednet. Supervising the insurance staff for randomly training and orientations for all type of approvals and companies to keep the department updated in case of a member vacation and other non availability as ER leave, Sick leave and absence.Participating overall activities related to Approval and other specific tasks from the high management.

Rejection responsible for all active insurance companies.Supervision of all medical rejections, justifications, appeals and resubmissions. Monitors and supervision of medical claims collectors.To ensure that all items which have been rejected or suspended by an insurance company are speedily dealt with by providing the required extra information or missing documentation.Facilitates and monitors access to patient’s files and medical record, coordinates meetings with treating physicians.Scanning the medical insurance (rejection) system and statistics and reports.Repeatedly taking reports and statistics from HMIS and FMIS statements for each active insurance company.

Receiving of claims from medical facilities and registry according to IMS system.  Analyzing report and statistics of entered claims for management and final summary for medical facilities.Responsible for all incoming approvals from medical facilities, checking the patient and policy terms, conditions approval and pre-existing limits.Forwarding approvals to assign doctor for final decision and sending back to medical facilities.To ensure that all invoices of insured patients are correctly raised and are supported by the relevant documents such as ID, medical reports, company referral, pre-approval etc, and are raised and dispatched in good time.Analyzing report and statistics of entered claims for management and final summary for medical facilities.

Receiving of medical claims from medical facilities and registry according to IMS system.Preparing claims batch wise for coding, providing complete information to coding department related to current batch.Forwarding claims to entry section after coding.Monitor the entry system and claims after entry and segregation of accepted and rejected claims for final review.Analyzing report and statistics of entered claims for management and final summary for medical facilities.