Mmaboelnoor M.

Key Skills

Software

Don't disclose

Top Subject Matter

Medical insurance claim approvals and healthcare regulatory compliance

Medical insurance claim auditing and compliance

Medical insurance claim auditing

Top Data Types

Text

Document

Top Task Types

Classification

Freelancer Overview

Approval Senior Specialist – RCM Approval Department (Saudi German Hospital, Remote/Offshore). Brings 7+ years of professional experience across complex professional workflows, research, and quality-focused execution. Core strengths include Don't disclose. Education includes Bachelor of Science in Clinical Pharmacy, Cairo University (2021) and Master of Science (Master’s Candidate), Cairo University (2021). AI-training focus includes data types such as Text and labeling workflows including Classification.

Labeling Experience

Approval Senior Specialist – RCM Approval Department (Saudi German Hospital, Remote/Offshore)

Don't discloseTextClassification

Reviewed and evaluated medical claims by applying insurance and healthcare policy criteria to determine approval outcomes. Performed case validity and medical necessity assessments and documented decisions for downstream processing. Supported team onboarding and coordinated with onsite members to handle delays and denials from insurance companies. • Worked in a remote/offshore RCM approval department focused on claim adjudication decisions. • Trained newcomers and assisted with integration with onsite teams. • Managed weekly team schedules and claim request workflows. • Ensured adherence to regulatory compliance requirements during reviews.

2023 - Present

Approval Specialist – RCM Approval Department (Saudi German Hospital, Remote/Offshore)

Don't discloseTextClassification

Evaluated and approved medical claims by verifying adherence to insurance policies and healthcare regulations. Collaborated with healthcare providers to assess case validity and medical necessity before approval actions. Ensured accurate documentation of adjudication decisions to reduce processing errors. • Performed claim evaluation focused on compliance and medical necessity. • Coordinated with providers during remote/offshore claim review. • Contributed to maintaining consistent approval standards within the department. • Supported workflow quality through careful validation of submitted claim information.

2023 - 2025

Approval Senior – Wadi El Neel for Medical Services

Don't discloseTextClassification

Processed and audited medical claims to ensure compliance with insurance policies. Coordinated with medical teams to streamline approvals and reduce claim delays. Applied structured checks to confirm claims met required criteria before approval workflows progressed. • Audited claim information for policy compliance. • Coordinated with clinical teams to improve approval turnaround times. • Contributed to reducing delays for pending or incomplete claim submissions. • Helped maintain consistent adjudication practices during the review period.

2023 - 2023

Approval Doctor & Claims Auditor – Omega Care for Healthcare

Don't discloseTextClassification

Reviewed and audited medical claims for accuracy and compliance prior to approval processing. Detected and helped prevent potentially fraudulent claims while optimizing the approval workflow. Produced review outcomes based on policy rules to improve decision reliability. • Performed compliance and accuracy checks on submitted claims. • Identified suspicious patterns indicative of fraud. • Optimized claim review workflows by refining evaluation steps. • Ensured approved or rejected decisions aligned with relevant requirements.

2021 - 2022

Education

Work History