Menna Elshahed
6th Of October City,
Summary
A dedicated and attentive pharmacist who is eager to learn, with over 3 years of experience in the insurance field. Looking for a fulfilling position in a reputable organization where I can challenge my potential, put my skills to good use, and grow my career exponentially.
Overview
7
7
years of professional experience
Work History
FWA – Medical Data Analyst
Med Right for medical services
10.2024 - Current
- Performing deep analysis to providers and members to identify any fraudulent trends or patterns.
- Creating dashboards using Power BI to visualize key metrics and insights.
- Performing a deep analysis for the policies before renewals.
- Proficient in data mining, statistical analysis, and reporting using tools like Excel and Power BI.
- Identifying patterns, then drawing meaningful conclusions with a problem-solving mindset.
- Putting confirmed fraudulent members and providers under supervision to limit abusive behaviors
Reimbursement Claims Officer
Mednet Egypt
06.2022 - 09.2024
- Record the received invoices in the database system, and determine policy coverage while calculating claim amounts.
- Processing claims after ensuring they comply with the insurance company’s regulations and policies, and sticking to their TAT.
- Deliver excellent customer service to insurance companies and insured members, with a view to achieving maximum client satisfaction.
- Monitor utilization rates and minimize fraudulent, abusive behaviors, and any duplications.
Reimbursement Auditor
Misr Healthcare Network
10.2021 - 05.2022
- Responsible for reviewing the patient’s itemized charges and medical records to verify that the invoice accurately reflects the supplies and services received.
- Following up with the accounts for any queries or requests.
- Communicating with Misr Insurance daily for payments.
- Separating the rejections and communicating with the account managers to make sure they inform the clients about the missed documents.
Community Pharmacist
Ezz-Eldeen Pharmacies
10.2020 - 09.2021
- Working as a community pharmacist. Responsible for dispensing medications to the public and selling OTC drugs.
- Exposed to the medical insurance systems. Requesting medical approvals and dispensing chronic medications for medically insured members.
Clinical Pharmacist Intern
Om Elmasryeen Hospital
06.2019 - 07.2019
- Reviewing records of patients to determine the appropriate medicines needed, and evaluating patients' health conditions.
- Minimizing the medications taken as much as possible to avoid any interactions or complications.
QA, QC and Production Intern
SEDICO pharmaceutical company
08.2018 - 09.2018
- Performing QA and QC tests on non-sterile dosage forms such as tablets, capsules, suppositories, and syrups.
Medical Clinic Intern
General Motors Egypt
07.2018 - 08.2018
- Performing QA and QC tests on non-sterile dosage forms such as: Tablets, Capsules, Supp, and syrups.
Education
BSc in Pharmacy And Pharmaceutical Sciences
Modern Science And Arts University –MSA University
2015-2020 Skills
- Data visualization and reporting - Power BI
- Statistical Analysis and data mining
- Excellent command in using Microsoft office applications
- Analytical and problem solving
- Eager to learn
- Detail-Oriented
Timeline
FWA – Medical Data Analyst
Med Right for medical services
10.2024 - Current
Reimbursement Claims Officer
Mednet Egypt
06.2022 - 09.2024
Reimbursement Auditor
Misr Healthcare Network
10.2021 - 05.2022
Community Pharmacist
Ezz-Eldeen Pharmacies
10.2020 - 09.2021
Clinical Pharmacist Intern
Om Elmasryeen Hospital
06.2019 - 07.2019
QA, QC and Production Intern
SEDICO pharmaceutical company
08.2018 - 09.2018
Medical Clinic Intern
General Motors Egypt
07.2018 - 08.2018
BSc in Pharmacy And Pharmaceutical Sciences
Modern Science And Arts University –MSA University
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