Fathelrman Mofeeda

DOH-licensed Pharmacist with extensive experience in medical insurance operations, claims processing, corporate pharmacy services, and reimbursement support. Skilled in insurance claims management, medical billing, ICD-10 & CPT coding, eligibility verification, and compliance with insurance policies and regulatory standards. Demonstrated ability to reduce claim rejections, maintain confidentiality of patient data, coordinate with healthcare providers and insurance teams, and ensure accurate documentation with strong attention to detail.

Proficient in medical terminology, Microsoft Excel, Microsoft Word, and adaptable to fast-paced healthcare and insurance environments. Seeking a position in medical insurance coordination, claims processing, or healthcare administration within UAE healthcare systems.

Insurance / Corporate Pharmacist at Swiss Mediterranean LTD (2015-11 – 2022-10)

• Managed medication services for corporate and insured patients while ensuring compliance with insurance policies and coverage limits.
• Reviewed prescriptions for medical necessity, dosage accuracy, and formulary compliance before approval.
• Processed and reviewed medical insurance claims with high attention to detail and accuracy.
• Verified insurance eligibility and supported claims submission, reimbursement, and billing processes.
• Applied ICD-10 coding and medical terminology to prescriptions and healthcare documentation to ensure accurate billing and claims handling.
• Reduced claim rejection rates by approximately 15% through accurate documentation and adherence to insurance guidelines.
• Coordinated with healthcare providers and insurance representatives as a liaison to resolve approval and coverage issues.
• Maintained confidentiality of patient records and insurance documentation in accordance with audit and regulatory standards.
• Supported chronic disease medication programs to ensure continuity of care within insurance guidelines.
• Adapted effectively to changing insurance procedures, operational workflows, and healthcare requirements.
• Improved claim approval efficiency through accurate documentation and insurance compliance.
• Supported reduction in processing delays through streamlined claims verification workflow.

Master of Pharmacy in MPharm – Omdurman Islamic University

Bachelor of Pharmacy in BPharm – University of Khartoum