Sara Hashim Alfaki Mohamed Sara
Dubai,United Arab Emirates
Summary
Motivated professional with strong analytical skills and customer-centric mindset, seeking to leverage knowledge of policy interpretation and claim processes to efficiently resolve claims and enhance service delivery, with a dedication to learning new systems and contributing to team goals."
Overview
5
5
years of post-secondary education
Education
Training course - Medical Auditing, Dental Insurance and Australian Medical Coding
Innovative academy
Saudi Arabia ,Riyadh 02.2025 - 06.2025
Bachelor of Medicine, Bachelor of Surgery - Medicine
Sudan International University
khartoum,Sudan 09.2013 - 11.2018
Skills
1Performing technical audit on medical claim either online or offline
2Justifying the rejection reasons on system in rejection cases to facilitate the reconciliation process
3Proper implementation of agreement on claims in collaboration with the audit of invoice
4Review and reject cases that not medically indicated
5Reject services which not matching with patient gender or age
6Making sure that co-payment and discount are applied correctly
7Review the medical documents that attached with claim eg lab result
8Reject uncover cases
9Check sealing limit for insured during audit process
10Review on preauthorized claims
11Apply the Australian coding standard to clinical coding
12Assign complete and accurate codes from ICD-10-AM, ACHI and ACS for diseases ,conditions ,injuries and procedures
12Calm under pressure
Languages
Arabic
Native
English
Intermediate
Timeline
Training course - Medical Auditing, Dental Insurance and Australian Medical Coding
Innovative academy
02.2025 - 06.2025
Bachelor of Medicine, Bachelor of Surgery - Medicine
Sudan International University
09.2013 - 11.2018