Mugtaba Mohamed Email & Phone Number

Abu Dhabi Emirate, United Arab Emirates

Khartoum, Khartoum State, Sudan

Assess day-care and in-patient cases as per medical justification policy coverage.Summarize and revise medical cases for approval.Adjudication after thoroughly reviewed claims, determine appropriate payment or denial based on the insurance policy, relevant guidelines and regulations.Investigate health insurance misuse and abuse casesunderstanding of authorization, pre authorization, claim, re-submission, outlier and add on servicesGreat knowledge of insurance policy, auditing, CDI, medical coding and terminology.Communicate with various stakeholders including healthcare providers, insurance companies, and the patient. Requesting additional information or clarification explaining claims decision, or addressing inquiries and concerns.

Khartoum, Khartoum State, Sudan

1-Administrative Excellence: orchestrated seamless administrative processes, managing medical records and regulatory documents with precision.2-Event Coordination and Privacy Assurance: Spearheaded the coordination of workshops and meetings with various medical specialties, ensuring privacy and validity for applicants. Meticulously organized every logistical detail.3-Database Management and Compliance:Maintained and updated databases to the highest standards of accuracy and compliance with regulations.4-Effective Communication and Verification:Played a pivotal role in responding to inquiries, facilitating communication between key leaders, and verifying qualifications for doctor applicants. Ensured the smooth coordination of registration processes with a diverse team.

Khartoum, Khartoum State, Sudan

Conducting patient consultations and medical examinations to diagnose and treat various health conditions.Providing primary healthcare services to patients of all ages, in ER.Evaluating patients' medical histories, symptoms, and test results to establish accurate diagnoses.Performing routine medical procedures such as vaccinations, suturing wounds, and minor surgical interventions.Ordering and interpreting diagnostic tests, such as blood tests, X-rays, and ultrasounds.Managing administrative tasks, such as scheduling appointments, documenting patient visits, and handling medical billing and coding.