Mohammed GalalEldein Hussein Hassan

• Follow up all pending approval request for in-patient & out-patient and assure that company approval is granted for
all services.
• Contact companies who have contracts with the hospital with relation to referral and approval of treatment.
• Provides information to patient concerning covered services and approval requirements under their company
health plan,
• Assure that all inpatient hospitalized within the approval limit,
• Fully aware and actively implement the departmental policies and procedures, local and international standards or
requirements related to the department.
• Handling medical claims and analyzing claim denials with proper medical justification
• Investigating the reasons for claim rejections and assessing their medical validity.
• Preparing detailed medical reports and appeals to support reconsideration of rejected claims.
• Communicating with insurance companies and administrative departments to resolve disputes and recover
payments.

Managing the healthcare organization’s budget
• Assisting in the training and promotion of the medical staff
11/2023 - 03/2024
• Ensuring that the medical staff and facility comply with the federal rules, regulations and codes
• Enhancing cooperation between Nurses, Physicians and relevant medical departments
• Fostering healthy relationships with suppliers as a way of keeping the medical center stocked
• Evaluating the coordination of the medical team to ensure the success of the institution
• Ensuring that licenses are up to date, thus preventing the prosecution or termination of the hospital’s services to
the public
• Evaluating and diffusing any tension that arises in medical units