Fady Elhady
Claims Department Supervisor
Cairo,
Summary
Multi-line Claims Supervisor dedicated to quality investigation, adjustment and supervision of diverse cases. Blends strategic planning and leadership strengths to establish top-performing claims departments. Trains and mentors staff, optimizing compliance with policies, procedures and applicable laws.
Professional in claims management with proven ability to lead teams and drive results. Extensive experience in process optimization and resolving high-stakes claims. Known for strong team collaboration and adaptability, bringing valuable skills in strategic planning and operational efficiency.
Overview
2024
2024
years of professional experience
8
8
years of post-secondary education
2
2
Languages
Work History
Claims Department Supervisor
TCS (Total Care Saudi)
2019 - 05.2023
- Perform technical audit on medical claims.
- Participate in audits and reviews to improve the accuracy of claims and reduce denials.
- Justify the rejection reasons on system in rejection cases to facilitate the reconciliation process.
- Assess the medical necessity of inpatient services provided and ensure that the documentation supports the claims.
- Proper implementation of agreements on claims in collaboration with the audit and processing team.
- Audit of invoice
- Monitored team performance, enforcing compliance with corporate claims processes and procedures.
- Built talented teams of 30 claims administrators dedicated to timely and compliant resolutions.
Claims Processor
TCS (Total Care Saudi)
2018 - 2019
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality
- Reduced claim processing time for faster customer service and improved satisfaction rates.
- Managed workload and priorities to meet claims processing meet deadlines.
Radiologist
El Demerdash Hospital
2014 - 2017
- Performed diagnostic imaging procedures such as positron emission tomography (PET), computer tomography (CT) and magnetic resonance imaging (MRI) in addition to traditional x-ray imaging in support of physician teams engaged in patient treatments.
- Determined appropriate testing procedures and protocols relevant to patient conditions and needs.
- Interviewed patients and reviewed documented histories to gain solid picture of relevant data.
Internship Student
El Demerdash Hospital
2010 - 2013
Education
Master of Science - Radiodiagnosis
Faculty of Internal Medicine And Surgery
Ain Shams University 01.2014 - 01.2016
Bachelor of Science - Internal Medicine
Faculty of Internal Medicine And Surgery
Ain Shams University 09.2004 - 01.2011
Skills
Claims analysis
Claims auditing
Claims processing
MS office suite
Team building
Team management
Time management abilities
Multitasking Abilities
Timeline
Master of Science - Radiodiagnosis
Faculty of Internal Medicine And Surgery
01.2014 - 01.2016
Bachelor of Science - Internal Medicine
Faculty of Internal Medicine And Surgery
09.2004 - 01.2011
Claims Department Supervisor
TCS (Total Care Saudi)
2019 - 05.2023
Claims Processor
TCS (Total Care Saudi)
2018 - 2019
Radiologist
El Demerdash Hospital
2014 - 2017
Internship Student
El Demerdash Hospital
2010 - 2013
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