Ahmed Gamal Eldin Mahmoud

Senior Medical Adjudicator

• Job Details:Review and audit inpatient claims from private and MOH healthcare providers, verify claims accuracy on the NPHIES platform and ensure coding compliance, coordinate with medical providers to resolve high-complexity claims issues, interpret medical reports and ensure alignment with insurance policy conditions.

Consultant – OB/GYNFull Time

• Job Details:-Supervising OB/GYN surgeries, deliveries, and resident doctors -Managing high-risk gynecological cases

Claim Manager

• Job Details:Managed multiple teams across adjudication, reconciliation, and data entry units, oversaw adjudication of high-volume inpatient/outpatient claims and implemented workflow efficiencies, handled provider inquiries and resolved rejection complaints professionally, directed utilization review reports to identify and mitigate financial losses for insurers, conducted medical service mapping and pricing strategy optimization.