BESHYOY SHERIF
Cairo
Summary
Results-driven professional with expertise in preauthorization management, quality improvement, and emergency response. Proven ability to mentor teams and enhance operational efficiency, contributing to streamlined processes and improved patient care.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Pre-authorization and Assistance Unit Head
Medmark insurance TPA
Giza
11.2024 - Current
- Managed all requests and inquiries from top management and board members.
- Facilitated pre-authorizations and follow-ups for a variety of member requests.
- Assisted members with emergency preauthorization needs during hospital admissions.
- Coordinated referral requests for both local and international providers.
- Contacted providers to obtain necessary medical information for preauthorizations.
- Advised on nearest medical facilities, ensuring access to effective treatment.
- Mentored junior advisors, enhancing their professional growth and team effectiveness.
- Conducted operational reviews, identifying key areas for improvement.
Pre-authorization and Assistance Senior Advisor
Medmark insurance TPA
Giza
11.2021 - 11.2024
- Answer members/providers inquiries received over the phone and via email, as well.
- Handle requests from different members/providers to obtain pre-authorizations and follow-ups.
- Assist members during emergency situations by facilitating their preauthorization request during admission and advising them on the nearest medical facility to go to and receive adequate treatment.
- Assist members concerning referral requests for providers, either inside or outside Egypt.
- Contact providers to obtain medical information needed to preauthorize the case.
- Mentored junior advisors, fostering professional development and enhancing overall team performance.
- Developed effective improvement plans in alignment with goals of advancing the Assistance portfolio in the company.
- Conducted regular reviews of operations and identified areas for improvement.
- Helped meet changing demands by recommending improvements to business systems or procedures.
- Devised and implemented processes and procedures to streamline operations.
Pre-authorization and Assistance Advisor
Medmark insurance TPA
Giza
04.2019 - 11.2021
- Answer members/providers inquiries received over the phone and via email, as well.
- Handle requests from different members/providers to obtain pre-authorizations and follow-ups.
- Assist members during emergency situations by facilitating their preauthorization request during admission and advising them on the nearest medical facility to go to and receive adequate treatment.
- Assist members concerning referral requests for providers, either inside or outside Egypt.
- Contact providers to obtain medical information needed to preauthorize the case.
Pre-authorization and Assistance Coordinator
Medmark insurance TPA
Giza
12.2016 - 04.2019
- Respond to emergency situations 100 %
- Respond to all referrals, appointments on time
- Update collective referrals list outside egypt
- Ensure 100 % successful medevac missions
- Respond to pre-auth request on time
Community Pharmacist
Farhat pharmacy
Cairo
01.2021 - Current
- Educated patients about possible drug interactions and gave special administration instructions.
- Reduced medication errors within the pharmacy by developing and implementing a continuous quality improvement program.
- Dispensed medications accurately to patients based on prescriptions.
- Provided counseling on medication usage and potential side effects.
- Managed inventory levels and ordered pharmaceutical supplies as needed.
- Assisted in training pharmacy interns on daily operational tasks.
- Maintained compliance with regulatory standards and safety protocols.
- Communicated with member physicians to prevent harmful drug reactions, therapy duplications, and allergic reactions.
Education
Bachelor's - Pharmacy and biotechnology
German University
Cairo07.2016
Skills
- Preauthorization management
- Quality improvement
- Medication counseling
- Emergency response
- Referral coordination
- Patient education
- Team mentoring
- Effective communication
- Process optimization
- Microsoft Office proficiency
- Time management
Languages
Arabic
First Language
English
Proficient (C2)
C2
Certification
- Data analytics program at ALX
- Strategic thinking tips to solve problems and innovate
- ATR pharmacist certificate
- Digital marketing by Udacity
Timeline
Pre-authorization and Assistance Unit Head
Medmark insurance TPA
11.2024 - Current
Pre-authorization and Assistance Senior Advisor
Medmark insurance TPA
11.2021 - 11.2024
Community Pharmacist
Farhat pharmacy
01.2021 - Current
Pre-authorization and Assistance Advisor
Medmark insurance TPA
04.2019 - 11.2021
Pre-authorization and Assistance Coordinator
Medmark insurance TPA
12.2016 - 04.2019
Bachelor's - Pharmacy and biotechnology
German University
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