Riham Awad Email & Phone Number

Ontario, Canada

Ontario, Canada

Dubai, UAE

• Adjudicated claims utilizing a multidisciplinary claim management model to; ensure objective, fair and thorough claim adjudication, comply with practices and procedures and regulatory requirements, provide the highest.
• Maintained patient confidentiality and claims integrity following company policies
• Delivered timely service to the members, providers, billing departments on the subject of claims
• Responded to customer enquiries accurately and professionally and liaised with other departments for support to ensure an efficient and professional response is given thereby achieving customer satisfaction
• Reviewed and adhered to all Company policies and procedures and the Employee Handbook
• Reviewed documentation about treatment overseas and coordinated and checked if covered as per policy terms and conditions before the issuing of appropriate approvals

Dubai, UAE

• Analyzed current processes and identify gaps or defects to improve the overall effectiveness
• Recommended process improvements to meet current and future customer service standards
• Processed paper and electronic claims (UAE, KSA & ROG) into the claims system and determined correct payment or denial amounts and documented notes as appropriate
• Identified and referred questionable claims, authorizations, and system issues to appropriate Senior Claims Analyst. Processed responses accordingly
• Researched and processed claim payment adjustments resulting from customer service referrals, audits or data inaccuracies as detected
• Handled FTP (fast track payment) claims and payments

Sharjah, UAE

* Dispensed prescription medication and other medical products to patients under the direction of licensed pharmacist* Performs administrative duties, including answering phones, receiving and inputting prescription orders, operating cash registers, and restocking inventory* Liaises with healthcare providers and patients to obtain correct prescription.

Sharjah, UAE