Nourhan A.Hassan Hafiz
Maadi cairo,Egypt
Summary
Experienced professional focused on providing high-quality patient care in the healthcare insurance field. Capable of assessing medically necessary interventions needed in case management and outpatient claims while also ensuring cost efficiency in medical decisions. With clinical expertise, paying attention to detail, along with strong communication skills collectively resulting in continuous achievements and excelling during past and current role. Currently looking for upgrading roles that create space of continuous learning and professional growth in the field
Overview
2
2
years of professional experience
5
5
years of post-secondary education
1
1
Certification
Work History
MGCC HELPLINE OFFICER
NEXTCARE ALLIANZ PARTNERS
New Cairo, Cairo Governorate
04.2024 - Current
- As Medical Helpline Officer operating remotely in Egypt for United Arab Emirates, Ifacilitate prior authorizations for diagnostic testing and therapeutic interventions in all outpatient settings while handling average of more than 80 calls from medical providers and customers on daily basis
- That includes intensive case management, managing chronic and high-cost medication by liaising with healthcare providers, and medical facilities while also prioritizing cost containment and strictly adhering to DHA, MOH, and DOH regulations.
- Over current work period, have consistently minimized financial loss to be always kept at less than 1% of total daily authorized claims and contributing to cost containment by increasing profit margin by at least 10% in 2024
- Additionally, part of daily tasks is providing comprehensive policy benefits interpretation and medical information for resolving beneficiary inquiries concerning their healthcare insurance plans.
- Lastly, largely contributing to MGCC helpline team development that consists of 70 team members through training initiatives, providing team assistance and coordinating effectively with the pre-certification and claims departments
PATIENT CARE OFFICER
MED-RIGHT FOR MEDICAL SERVICES
Maadi , Cairo Governorate
07.2023 - 04.2024
- Provided highly optimized patient care coordinated across multiple hospital settings (As-Salam International and Air Force Specialized Military Hospital).
- Managed prior authorizations for diagnostic and pharmaceutical interventions (inpatient/outpatient).
- Streamlined claims and billing processes through direct communication with patients, physicians, and hospital administration
- Served as liaison, ensuring efficient hospital-company communication, and cultivated relationships with high-profile clients.
Education
Bachelor's degree, Bpharm - Clinical Pharmacy
Cairo University
Cairo, Cairo Governorate 09.2018 - 06.2023
Skills
- Pharmaceutical Research & Development Intern KiroVest Pharmaceutical [august 2022] Gained understanding of drug development in the MENA region and its impact on healthcare costs
- Community Pharmacy Intern [AL - YAMANI PHARMACY] [July 2021 -September 2021] Acquired knowledge of clinical pharmacotherapy, home medication management and patient education
- Clinical Pharmacist Intern Maadi Military Hospital Medical Complex [July 2022] Developed expertise in patient medication adherence, adverse reaction monitoring, and drug interactions, crucial for patient support
Certification
- U.S. Health Law Fundamentals ( UNIVERSITY OF PENNSYLVANIA )
- MedCertsMedical Billing and Coding Essentials Medical Billing and Coding Essentials (MED-CERTS )
- Customer Service Foundations ( NASBA )
Timeline
MGCC HELPLINE OFFICER
NEXTCARE ALLIANZ PARTNERS
04.2024 - Current
PATIENT CARE OFFICER
MED-RIGHT FOR MEDICAL SERVICES
07.2023 - 04.2024
Bachelor's degree, Bpharm - Clinical Pharmacy
Cairo University
09.2018 - 06.2023
- U.S. Health Law Fundamentals ( UNIVERSITY OF PENNSYLVANIA )
- MedCertsMedical Billing and Coding Essentials Medical Billing and Coding Essentials (MED-CERTS )
- Customer Service Foundations ( NASBA )
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