SAMI ELSAIED TAHA SAEED

* Pre-authorization Doctor for more than 3 years.

* Auditing, Coding, Reviewing, Monitor and Evaluation experiences.

• Used administrative guidelines as resource or to answer questions when processing medical claims.
• Educated clients on insurance policies and procedures.
• Analyzed risk factors to recommend appropriate coverage levels.
• Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
• Verified patient insurance coverage and benefits for medical claims.
• Identified and resolved discrepancies between patient information and claims data.
• Reviewed provider coding information to report services and verify correctness.
• Generated reports on medical claims processing activities and results.
• Assessed medical claims for compliance with regulations and corrected discrepancies.

• Communicated with managers of other departments to maintain transparency.
• Created and enforced department policies, procedures and standards to establish productivity and quality.

Auditing, Coding, Reviewing, Monitor and Evaluation.