Kamal Emad

Senior medical operation specialistFull Time

• Job Details:Review and analyze medical claims for accuracy and completeness of information Verify member eligibility and coverage details according to their plan. Investigate potential claim discrepancies by researching medical records, contacting providers, and gathering necessary documentation Determine appropriate reimbursement based on policy provisions and benefit schedules Negotiate settlements with healthcare providers as needed Communicate claim decisions to members and providers clearly and professionally Maintain accurate and detailed claim records Identify and prevent potential fraud, waste, and abuse within the claims process. Onboarding the new accounts, reviewing their contract and invoices Building strong relation with the clients and surveying their satisfaction. Monitoring the consumptions and loss ratios, and take actions accordingly. Handling the renewal process

Shift leader Medical approval/Customer success officerFull Time

• Job Details:The Customer success officer will own and manage customer relationships and ensure delivery of great service to clients. Provide clients with the necessary external and internal support needed for the smooth and efficient running of their activities, to assure that all terms and conditions of contractual agreement are well coordinated. Act as a single point of contact for the client and attends to customer issues promptly. Keeps account information in relevant files and databases. Handle & Follow up Medical approvals process for clients through Emails , whatsapp & Mobile