Rana EL-Balshash
Kuwait City,KU
Summary
I am an enthusiastic person, self-motivated with lots of personal abilities; I am looking for a position in a well reputed organization where I can utilize my professional knowledge, skills and experiences. Results-driven [Chief Medical Insurance officer ] experienced in medical insurance financial statement review, auditing and reporting. Well-versed in producing reports, evaluating department operations and handling month- and year-end closings. Meticulous, conscientious and methodical in approach worked in insurance field from insurance companies point of view and provider with collaborative information in this field .
Overview
13
13
years of professional experience
1
1
Certification
Work History
Chief Medical Insurance Officer
Alsalam Hospital Company
11.2016 - Current
- AS executive members in Alsalam hospital company managing medical insurance department to all hospital branches .
- Team management of around 70 Staff in all branches related to medical insurance department .
- Pricelist creation based on international CPT coding .
- finalizing pricelist agreement with all insurance companies .
- timely submission for all insurance companies with maintaining less rejection rate .
- Contracts verification and finalization of contracts, Training and Orientation to Medical and Non-Medical staff, Claims Management and Reporting on Performance, Business Development and Exploring Insurance Revenue
- Utilized financial software to prepare consolidated insurance financial statements.
- Established internal audit procedures to validate and improve accuracy of insurance financial reporting.
- Implemented and regularly reviewed insurance revenue controls to generate accurate and reliable financial data.
- Developed strategic plans for day-to-day medical insurance operation
- Prepared internal and regulatory medical insurance financial reports, balance sheets and income statements.
- Complied with established internal controls and policies.
- Reviewed historical records, current operational data and forecasting information to identify and capitalize on system enhancement opportunities.
- Created medical insurance financial dashboards to provide insights into key performance indicators.
- Improved overall financial reporting by streamlining control processes and reporting structures.
- Collaborated with C-level executives and stakeholders to develop long-term financial plans.
- Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports.
Senior medical officer (Preapproval &claims department)
Gulf Life Insurance Company
03.2011 - 09.2016
- Preauthorization for all requests received for health care provider for individual and corporate policy, Manage routine daily claim administration work, Evaluating claims concerning eligibility, Coordinate work flow and meet deadlines, Decision of high cost, complicated inpatient cases, Attending call and e-mails form clients and provider, Business development issues, Increasing efficiency, minimizing errors and administration time, Claim reconciliation and resubmission process, Evaluating life insurance claims, Evaluating Reimbursement claims, Training of newly joined medical staff and setting guidelines for approval, Replying all complaints received from insured members
Education
Bachelor's degree in Medicine & Surgery -
Faculty of Medicine
01.2008
Skills
- Data Interpretation
- Claims Management
- Client Needs Assessment
- Records Management
- Technical Knowledge
- Strategy Development
- Data Analysis
- Staff Recruitment and Hiring
- Team Building Leadership
- Critical Thinking
- Decision-Making
- Work Planning
- Quality Assurance
- Staff Management
- Excellent Communication
- Problem-Solving
- Teamwork and Collaboration
- Risk Analysis
Certification
- Certified Chartered Insurance Institute CII
- Certificate in leadership strategies for evolving healthcare Executive (Harvard University)
- Mastering in presentation and Public speaking (AUK)
Additional Information
Well organized, Managing skills, Leadership skill, Ability to work under stress, Time management, Good communication & computer skills
Marital Status
Married
Residency
Transferable Visa
Personal Information
- Date of Birth: 08/24/84
- Nationality: Egyptian
Training
- Communications skills
- Health care project management
- Business writing skills
- Computer skills
- Training in all department in Almery hospital Alexandria for clinical information
Timeline
Chief Medical Insurance Officer
Alsalam Hospital Company
11.2016 - Current
Senior medical officer (Preapproval &claims department)
Gulf Life Insurance Company
03.2011 - 09.2016
Bachelor's degree in Medicine & Surgery -
Faculty of Medicine
Similar Profiles
Anu Pavithra JohnsonAnu Pavithra Johnson
NA at Alsalam Health Medical Hospital/ Long term care unitNA at Alsalam Health Medical Hospital/ Long term care unit
Mahmoud MaherMahmoud Maher
acountant at Alsalam Hospitalacountant at Alsalam Hospital
ESRAA AHMED QATOONESRAA AHMED QATOON
Emergency Medicine Intern at AlSalam HospitalEmergency Medicine Intern at AlSalam Hospital
Wassim DandachlyWassim Dandachly
Senior Operations Manager at Tariq AlGhanim LimitedSenior Operations Manager at Tariq AlGhanim Limited
MAHMOUD HAMOUDEHMAHMOUD HAMOUDEH
branch sales team leader at NAbranch sales team leader at NA