Basic Info

Ibrahim Ayad

10 years

Giza, Egypt

Bachelor's Degree

Experienced

Work Experience

Medical claim auditing unit head at Andalusia group for medical sevices

Experience Details

Medical claim auditing unit head

Medical/Healthcare

Manager

Implement and develop reporting system that measures accurately KPI's of associates.
Medical auditing for all documents and reports related to contracted patients (medically covered by insurance company directly or indirectly)
Ensure that the operation instruction of contracted companies correctly applied.
Supervise prior approvals and guarantee full payment claims.
Manage re-submission requests to minimize deducted amounts.
Coordinate between different hospital departments to ensure full harmony1


Company Details

Andalusia group for medical sevices

Cairo, Egypt

More than 1000 employees

Healthcare and Medical Services

http://www.andalusiagroup.net

Jun 2016 to present (6 months)
Senior Medical Claim Adjuster at Metlife

Experience Details

Senior Medical Claim Adjuster

Accounting/Finance

Experienced (Non-Manager)

Duties and responsibilities:
------------------------------------------

1) Responsible for training newly hired adjusters.

2) Handle the claims received from the medical providers and policy-owners to decide the payment within the turnaround time (TAT) .

3) Make sure that the checks of the providers and the policy owners are issued on time and immediately sent out.

4) Ensure that the claims payment decision taken are within the authority given to the adjuster by the company and complies with the contract.

5) Coordinate with other departments on issues requiring their respective involvement such as Accounting and Group departments.

6) Ensure accuracy and timely generation of periodical reports.

7) Comply with MetLife code of conduct, and ensure that it’s fully adhered to all the time.

8) Carry some assignment related to my talent in Microsoft Office ( Word , Excel and Power point ) and give help for other departments need to benefit from my presentation and data analysis skills.

*******************************************

Achievements:
---------------------
* Top ten runners, one of Bouquet Of Excellence at multinational
life and medical health insurance company.

* Award of exceptional performance for thinking out of the box and increase
productivity thanks to system modifications.

* Introducing new approaches and modifying work flow to be faster, accurate and valid.

* Creating advanced smart macro-enabled excel sheets that facilitate work tasks and saves time and effort as well.

* Planning a reporting system that evaluates the exact and actual productivity of associates according to the guide lines settled by the management.

* Enhance customer satisfaction by improve the quality of service introduced to them, and widen the contact channels between associates and customers.

* Designing a professional, holistic and conclusive presentation with sales flavor to help retain business and build opportunities for the sales team.


Company Details

Metlife (multinational)

Cairo, Egypt

More than 1000 employees

Insurance

https://www.metlife.com

Nov 2010 to May 2016 (5 years 6 months)
Full time Medical Representative at Geopharma

Experience Details

Full time Medical Representative

Medical/Healthcare

Experienced (Non-Manager)

Best achiever and Track record for 4 successive quarters at promotion career
in CVS line working on a lipid regulator product in Giza, Haram, Faisal , October
city, Giza Suburbans Area.


Company Details

Geopharma

Cairo, Egypt

11-50 employees

Pharmaceuticals

N/A

Mar 2009 to Nov 2010 (1 year 8 months)
Pharmacy Manager at Pharma Pharmacy , Mohamed Salah Pharmacy

Experience Details

Pharmacy Manager

Pharmaceutical

Manager

Follow up reports of daily sales, Purchase Bills, Monthly Payment, Salaries, etc....


Company Details

Pharma Pharmacy , Mohamed Salah Pharmacy

Cairo, Egypt

1-10 employees

Pharmaceuticals

N/A

Aug 2008 to May 2009 (9 months)
Community Pharmacist at Reda

Experience Details

Community Pharmacist

Pharmaceutical

Experienced (Non-Manager)

Creating follow up card for customers including:
Name, address, contact numbers, diseases, contra indicated drugs.


Company Details

Reda

Giza, Egypt

1-10 employees

Pharmaceuticals

N/A

Jun 2005 to Jul 2008 (3 years 1 month)

Achievements


Ton ten runners, one of Bouquet Of Excellence at multinational
life and medical health insurance company.
* Award of exceptional performance for thinking out of the box and increase
productivity thanks to system modifications.
* Introducing new approaches and modifying work flow to be faster, accurate and
valid.
* Creating advanced smart macro-enabled excel sheets that facilitate work tasks and
saves time and effort as well.
* Planning a reporting system that evaluates the exact and actual productivity of
associates according to the guide lines settled by the management.
* Enhance customer satisfaction by improve the quality of service introduced to
them, and widen the contact channels between associates and customers.
* Designing a professional, holistic and conclusive presentation with sales flavor to
help retain business and build opportunities for the sales team.



Best achiever and Track record for 4 successive quarters at promotion career
in CVS line working on a lipid regulator product in Giza, Haram, Faisal , October
city, Giza Suburbans Area.


Ranked as one of Top 300 students allover EGYPT in Thanawya Amma

Education

Pharmaceutical Science in Pharmaceutical Science

Education Details

Pharmaceutical Science

Pharmaceutical Science

Cairo University, Egypt

B / Very Good / 75 - 85%

N/A

N/A

Cairo University
2000 - 2005
High School - Thanaweya Amma

High School Details

Thanaweya Amma

Saiedeya military secondary school

Egypt

1999

A / Excellent / 85 -100%

Ranked as top 300 students all over EGYPT

Saiedeya military secondary school
1999

Certifications

Certificate details

Certificate of Appreciation

Jun 2015

N/A

http://imgur.com/a/8dHQP

N/A

Metlife

Some quotations and appreciations words said and sent to me during working for MetLife.

Training and Courses

Training/Course Details

Records Management

May 2015

MetLife Compliance and Ethics Learning Center

N/A

Training/Course Details

FATCA (Foreign Account Tax Compliance Act)

May 2014

MetLife Compliance and Ethics Learning Center

N/A

Training/Course Details

Prevention of fraud in the insurance sector

Apr 2014

MetLife Compliance and Ethics Learning Center

N/A

Training/Course Details

Anti bribery and Corruption: global overview

Jun 2013

MetLife Compliance and Ethics Learning Center

N/A

Training/Course Details

Combating Money Laundry in insurance companies

Jul 2012

MetLife Compliance and Ethics Learning Center

N/A

Training/Course Details

Information security

May 2012

MetLife Compliance and Ethics Learning Center

N/A

This profile is not updated!
Last update more than 1 months ago.

Jobseeker photo

Profile Skills and Keywords

AccountingAnalyticalAnti Bribery And Corruption: Global OverviewArabicB1MCOCertificate Of AppreciationCombating Money Laundry In Insurance CompaniesCommunity PharmacistCreativeCustomer-orientedCyclingEnglishFATCA (Foreign Account Tax Compliance Act)FinanceFull Time Medical RepresentativeHard WorkerHealthcare And Medical ServicesInformation SecurityInnovativeInsuranceInternet BrowsingInternet SearchMedicalMedical Claim Auditing Unit HeadMedical Data ProcessingMedical InsuranceMedical RepresentationMetlifeMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointMicrosoft WindowsMicrosoft WordPharmaceuticalPharmaceutical SciencePharmaceuticalsPharmacy ManagerPrevention Of Fraud In The Insurance SectorReadingRecords ManagementSenior Medical Claim AdjusterSocial MediaSports (mainly Foot Ball)

Self-assesed Skills

Languages

Arabic

Arabic

: Fluent

: Fluent

: Fluent

: Fluent

English

English

: Fluent

: Advanced

: Intermediate

: Intermediate

Tools and Technologies

Microsoft Word

Microsoft Word

: Expert

: Extreme - I love it!

:

More than 7 years

Microsoft Excel

Microsoft Excel

: Expert

: Extreme - I love it!

:

5-7 years

Microsoft Windows

Microsoft Windows

: Expert

: Extreme - I love it!

:

More than 7 years

B1MCO

B1MCO

: Expert

: High

:

5-7 years

Social Media

Social Media

: Expert

: Extreme - I love it!

:

More than 7 years

Microsoft PowerPoint

Microsoft PowerPoint

: Advanced

: Extreme - I love it!

:

3-5 years

Microsoft Outlook

Microsoft Outlook

: Advanced

: Extreme - I love it!

:

5-7 years

Internet Search

Internet Search

: Advanced

: Extreme - I love it!

:

5-7 years

Fields of Expertise

Pharmaceutical

Pharmaceutical

: Expert

: Extreme - I love it!

:

More than 7 years

Medical Data processing

Medical Data processing

: Expert

: Extreme - I love it!

:

5-7 years

Medical Insurance

Medical Insurance

: Advanced

: Extreme - I love it!

:

5-7 years

Medical representation

Medical representation

: Intermediate

: Medium

:

1-3 years

Key Skills

Analytical, Hard worker, Customer-oriented, Creative, Innovative

Online Presence

https://eg.linkedin.com/in/ibrahimayad2010http://www.facebook.com/ibrahim.ayadhttps://twitter.com/ibrahimayad15http://wuzzuf.net/me/DrIbrahimAyadhttp://people.bayt.com/ibrahim-ayad-29342177/https://eg.linkedin.com/in/ibrahimayad2010

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