Insurance , administrative

 

 

Amal Yahya Moubdi

Abu Dhabi – U.A.E.

Mobile : +971501312662`

E-mail : amalmoubdi@yahoo.com

 

 

Objective

  • Seeking a position with a well-established company where I can maximize my program development and training skills.
  • Work with a leading medical or non-medical facility as health insurance specialist and performing of medical insurance claims.
  • As well providing valuable services to patient (or Client) and access necessary medical services.

Jobs Description

 

As Health insurance specialists has generally skilled in many areas of medical billing including claims and payment processing, medical coding, and medical terminology.

 

As well Knowledge of computers, data entry, e-mail, and the Internet is essential.

Health insurance specialists excellent oral and verbal skills, as well as the ability to multi-task and assign priority level.

 

As Health insurance coordinator responsible for coordinating with people from several department on behalf of employing department .

 

Also my duties as Health insurance coordinator include coordinating with marketing, operations, receiving mails and distributing to various people in the office; preparing administrative and functional reports for the manager; receiving incoming calls; making calls.

 

coordinate typically reports to an insurance manage.

 

Career Objectives                                                  

 

  • I am seeking employment with a company where I can use my talents and skills to grow and expand the company.
  • I want to succeed in a stimulating and challenging environment, building the success of the company while I experience advancement opportunities.
  • I want to excel in this field with hard work, perseverance and dedication.
  • I want a highly rewarding career where I can use my skills and knowledge to help the company and my coworkers be successful.
  • I am seeking a company where I can use my experience and education to help the company meet and surpass its goals.
  • I want to be part of the success in an environment of growth and excellence.
  • I am seeking a competitive and challenging environment where I can serve your organization and establish an enjoyable career for myself.

 

 

 

Personal information

  • Date of birth : 27 July, 1984
  • Gender : Female
  • Place of birth : Al- Ain
  • Material status: married
  • Nationality   : Palestine
  • Visa : Husband  Visa
  • Driving license: Available

 

 

Personal Skills

Comprehensive problem-solving abilities, organizing and coordinating skills, good verbal and written communication skills, ability to deal with people, willingness to work in a team, work under pressure.

 

 

Education

 

 

United Arab Emirates University

 

Year             :             2007-2008

Institution    :     United Arab Emirates University, College of food and agriculture, department of nutrition and health.

Level Education: B.Sc. Degree in dietetics with grade of good.

 

Acorn Research

 

Year: August to September 2013

Institution: Acorn Research

Level Education: Certified Coding Associate (CCA)

 

Languages

  • Arabic native language.
  • English: Exultant (Written, spoken and reading).

 

 

 

 

 

 

WORK EXPERIENCE

 

  1. Burjeel Hospital :

 

  • Date : August 2015 until August 2017.
  • Position : Health Insurance Coordinator .
  • Address : Abu Dhabi .

 

Duties and Responsibilities :

  • Supervise, manage and monitor claims submission and re submission to ensure accuracy and processing insurance claims in timely approach.
  • Review and monitor denial reasons and discrepancies, processed claims to minimized revenue loss and maximize reimbursement.
  • Processed claim forms adjudicate for provision of deductibles, co-pays, co-insurance maximums and provider settlements.
  • Entered claims online for authorization request (PBM Link, E-Rx, Openjet) and coordinating with Dimensions healthcare for HAAD regulation rules and changes.
  • Entered claims data into system, reviewed and made sure that there is no omitted information, entered claims into computer utilizing knowledge of CPT, ICD codes and medical terminology.
  • Checking and review all claims we received from all clinics . Segregating Claims per facility, per insurance and per TPA.
  • Filing all submitted claims and duplicate of paper claims for audit purposes and re submission for our reference if in-case there is a denial.
  • Performing as a liaison between insurance company’s and provider concerning network agreements, and contract renewal.
  • Assist and conduct a training for the new hired staff regarding insurance policies and the claims department staff in carrying out their duties effectively.
  • Inform the staff about new circular received from the insurance companies and new insurance network added in our company.
  • Answered inquiries on subject of claim, eligibility, covered benefits, insurance inclusion, exclusions and approval status issues.
  • Obtain authorizations from respective Insurance providers for Healthcare services in the clinic.
  • Attend to the customer queries related to Health Insurance.
  • Responsible for assisting patients with the processing of insurance claims and coordinating with insurance companies and TPAs for getting the required claims approval and keeping its proper record.
  • Contacts insurance companies and patients regarding outstanding balances. Researches and resolves insurance billing issues.
  • Assists and reviews claims and E-claims pre and post submission to determine completeness, accuracy and collection of unpaid and denied claims.
  • Works closely with Patient Relations Manager, Customers Care Representatives, Nursing Staff, Insurance Manager and providers to ensure claims accuracy and processing.
  • Verifies new patients insurances and re-verifies that of patients coming back on service.
  • Submits pre-determinations for clinical medical necessity.
  • Enters data into the computer as needed .

 

 

  1. Cosmesurge and Emirates Hospital:

 

  • Date: 18 Jan 2012 until July 2014.
  • Position in Company: Insurance Coordinator
  • Company Name: Cosmosurge and Emirates Hospital
  • Company Industry: cosmetic and therapeutic.
  • Address: Abu Dhabi, United Arab Emirates.

 

 

Work Description:

 

Coordinating insurance approval requests with Medical Insurance Companies and be the liaison between Insurance Companies and Doctors with regards to insured procedures and services.

 

 

 

Duties and Responsibilities

 

  • Obtaining prior approvals for the services requiring pre-authorization
  • Coordinating with all doctors for any requirements from Insurance companies.
  • Coordinating with In-house doctors and Community doctors for all the issues related to insurance protocols.
  • Informing front desk staff for any new protocols received from insurance companies.
  • Daily Screening of credit invoices.
  • Ensuring approvals are received for any surgeries booked next day.

 

 

 

Communication

The Insurance Coordinator has to be clear and concise in communication to Insurance companies, doctors, staff (front desk ) and patients .

 

 

 

 

 

 

  1. VLCC ( VLCC slimming and beauty) :
  • Date: September 2009 till October 2011.
  • Position in Company: health instructor
  • Company Name: VLCC slimming and beauty
  • Company Industry: Beauty, Aesthetic & Dermatological Solutions
  • Address: Abu Dhabi, United Arab Emirates.

 

 

 

Work Description:

 

  • Sales of slimming programs covers a wide range of the latest devices technologies for skin tightening, weight loss, cellulite reduction, slimming treatments.
  • Sales of slimming products.
  • following client's health and nutrition status , as well as giving nutrition advice in ( calories or portions size of food for different people normal adult or some of special cases like diabetes , hypertensions , old people).
  • prepare and manage correspondence, reports and documents, maintain schedules and calendars, arrange and confirm appointments organize internal and external events ,handle incoming mail and other material, collate information maintain databases communicate verbally and in writing to answer inquiries and provide information liaison with internal and external contacts coordinate the flow of information both internally and externally operate office equipment manage office space.

 

 

 

 

  1. NEW MEDICAL CENTER :

 

  • Date: April 2008 to September 2008
  • Position in Company: secretary/ Receptionist
  • Company Name: new medical center
  • Company Industry: hospital
  • Address: Abu Dhabi, United Arab Emirates.

 

 

 

Work Description:

1-    arranging and filing medical cards and entering details,

2-    following patient's medical progress through specific computer program ,

3-    set up and maintain filing systems arrange and confirm appointments , implement and maintain office systems ,set up work procedures.

 

 

 

 

 

Professional Training

 

Dietetic Internship Experience in Shaikh Khalifa hospital for six weeks during June 2007 to July 2007.

 

 

 

exhibition and conferences

1-   Attend Nutrition Education Week in United Arab Emirates University organized by the Department of Nutrition and Health, from 25th to 29th March 2007.

2-   Attend Third Arabic Nutrition Conference held in Abu Dhabi during 4th - 6th Dec.2007 in Abu Dhabi.

3-   Participate in the exhibition of healthy food under the banner Your health in your diet under the auspices of the Family Development Foundation held in Al-Ain from 19th to 22nd Feb 2007

4-   Attend the lectures, workshops and activities held in UAE University especially in the College of Food and Agriculture during studying.

 

 

 

Presentation and publications

  • Senior research project about (Anthropometric Characteristics of UAE Children (Birth-5years) Using WHO Growth Standard and WHO/NCHS Growth Reference) by using SPSS program.
  • Comparison of the WHO Child Growth Standards and the CDC 2000 Growth Charts
  • Conducting a project on anemia during pregnancy, in Nima clinic in Al-Ain.
  • Gestation and Type 2 Diabetes presentation project.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COURSES

  1. Nutrition.
  2. Medical nutrition therapy.
  3. Nutrition education and communication.
  4. Human nutrition in various ages.
  5. Principles of food science and nutrition.
  6. Fundamentals of food preparation.
  7. Food service system management.
  8. Basic biology.
  9. General genetics.
  10. Meal planning.
  11. Public health nutrition.
  12. General chemistry.
  13. General physics.
  14. Computer science.

SKILLS

  • Computer Skill (Windows, Ms Office, SPSS, Excel, internet, Arabic and English Typing, computer literate (MS Word, MS Excel, MS PowerPoint).
  • Extensive knowledge of medical terminology, as well as experience using a computer.

 

PERSONAL SKILLS

-       Ability to get along with people

-       Ability to work on own initiative or as member of team

-       Ability to work under stress

-       Get things done within short period

-       Energetic and creative

-       Enthusiastic

-       Patient and can deal with difficult people without despair

 

 

Last Resume Update January 30, 2019
Address Abu dhabi, United Arab Emirates
E-mail Locked
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