AHMED MOHAME REDA

• Managing Payers and Providers Reconciliation Aspects For Payers
• Managing the Collection Cycle from the payers based on the dues
• Reconciling the payments and Investigate if any difference
• Data Analysis, Provision, Risk analysis and liabilities For Providers
• Managing the Cycle of the Providers Finance Reconciliation
• Monitoring the TAT and the cycle of the OPS
• Internal Auditing
• Review the Tax invoice and make sure the invoice is Correct.
• Reduced discrepancies in financial data by conducting thorough investigations and resolving issues promptly.
• Developed and maintained strong relationships with internal and external stakeholders to ensure smooth communication during the reconciliation process.

• Coordinate and distribute work on the team (inside and outside the company)
• Follow-up work procedures with them on an ongoing basis, and communicate with them permanently to ensure that work procedures are done as required
• Follow up and Solve any problem with providers or Policy Holder
• Send the required reports in a timely and required manner
• Communicating with the company's internal departments and responding to all inquiries required from all departments
• Support Mapping & Coding Team (Adding new price lists and services for providers on the system, with the addition of the discounts Agreed upon contracts for each provider)
• Support reconciliation Team (Review Deductions with providers and settle their debts).
• Developed team members'' skills through targeted coaching sessions, resulting in improved individual performance.
• Mentored junior staff members, helping them develop their leadership potential and advance in their careers.

* Review Claims before sending it to insurannces company.

* send the claims to insurances company in the required form.

* Follow up procedures for claims review in Misr insurance Company.

• Enhanced product quality by meticulously inspecting finished seams and making necessary adjustments.

* Delivered the Claims to the insurances Company in the time and in the form required after reviewing.

* Follow up with the insurances company and with internal departments.

* follow up the cycle of delivered claims.

• Improved patient care by maintaining accurate and up-to-date medical records for easy access by healthcare practitioners.
• Streamlined information retrieval processes, developing a comprehensive filing system for physical documents.
• Managed the secure transfer of medical records between facilities, ensuring proper adherence to privacy regulations and patient confidentiality guidelines.
• Developed efficient workflows for data entry tasks, enhancing overall productivity within the department.