Basic Info

Kerolos takla

4 years

Cairo, Egypt

Bachelor's Degree

Experienced

Work Experience

Supervisor Operations & Claims Auditing at Medical travel department (TPA) of Travel Choice Egypt

Experience Details

Supervisor Operations & Claims Auditing

Medical/Healthcare, Human Resources, Sales/Retail

Experienced (Non-Manager)

1-Operations and Authorizations.
Process approvals according to the policy of each insurance company.

Examination of claims and verify insurance eligibility .

Coordinate and perform verifications of insurance benefits.

 Reviewing patient's case and insurance coverage to personalize the call contents .

Provide clinical information as needed, emphasizing the medical information for the requested procedure to insurance companies for pre-authorization procedure.

Ensure referring physician obtains pre-authorization as needed from insurance company.

Assisting patients in obtaining and understanding medical benefits.

 

2- Planning.

3- Research and development .

4- Reviewing Hospitals contracts


Company Details

Medical travel department (TPA) of Travel Choice Egypt (multinational)

Cairo egypt, Egypt

More than 1000 employees

Travel and Tourism, Insurance, Healthcare and Medical Services

N/A

Oct 2012 to present (4 years 2 months)
Pharmacist at Zeikri pharmacy

Experience Details

Pharmacist

Medical/Healthcare

Experienced (Non-Manager)

N/A


Company Details

Zeikri pharmacy

Cairo -Egypt, Egypt

N/A

Pharmaceuticals

N/A

May 2009 to Jan 2015 (5 years 8 months)

Achievements


  Increase revenue and sales for our Medical Travel department by working on my two new projects which achieve a great success and satisfying results    

Education

very good in pharmacy

Education Details

very good

pharmacy

October 6 University, Egypt

B / Very Good / 75 - 85%

N/A

N/A

October 6 University
2005 - 2009
High School - Thanaweya Amma

High School Details

Thanaweya Amma

amoun private language school

Egypt

2005

A / Excellent / 85 -100%

N/A

amoun private language school
2005

Certifications

Certificate details

human resources certi9

Jul 2010

N/A

N/A

N/A

American University in Cairo

N/A

Training and Courses

Training/Course Details

Health Medical insurance

Feb 2016

insurance company

Initiating and track health insurance claims. How to resolve denied claims

This profile is fresh!
Last update 8 days ago.

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Profile Skills and Keywords

AdaptiveArabicBusiness DevelopmentCreativeEnglishFlexibleFootball MatchsHard WorkerHealth Medical InsuranceHealthcare And Medical ServicesHuman ResourcesHuman Resources (HR)Human Resources Certi9InnovativeInsuranceLearning Computer SkillsMedicalMedical InsuranceMedical Travel Department (TPA) Of Travel Choice EgyptMicrosoft ExcelMicrosoft OfficePharmaceutical FieldPharmaceuticalsPharmacistPharmacyPlannerPlanningRetailSalesSupervisor Operations & Claims AuditingSwimmingTravel And Tourism

Self-assesed Skills

Languages

English

English

: Advanced

: Advanced

: Advanced

: Advanced

Arabic

Arabic

: Fluent

: Fluent

: Fluent

: Fluent

Tools and Technologies

Microsoft Excel

Microsoft Excel

: Expert

: Extreme - I love it!

:

3-5 years

Microsoft Office

Microsoft Office

: Advanced

: Extreme - I love it!

:

3-5 years

Human Resources (HR)

Human Resources (HR)

: Advanced

: Extreme - I love it!

:

3-5 years

Fields of Expertise

pharmaceutical field

pharmaceutical field

: Expert

: Extreme - I love it!

:

3-5 years

medical insurance

medical insurance

: Advanced

: Extreme - I love it!

:

3-5 years

planning

planning

: Advanced

: Extreme - I love it!

:

5-7 years

Key Skills

Planner, Hard worker, Creative, Flexible / Adaptive, Innovative

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