Mohamed Elnadi

Healthcare finance and revenue cycle management professional with extensive experience in claims management, approvals, denials reduction, payer relations, and reimbursement optimization. Leveraging an MBA in Hospital Management and strong expertise in UHIA and private insurance workflows, I aim to drive financial performance, streamline operations, and enhance revenue integrity in progressive healthcare organizations.

RCM Manager at Sharm El Sheikh International Hospital (2024-08 – Present)

• Oversee and improve all aspects of the revenue cycle, from patient registration to final payment.
• Lead the full revenue cycle operations including billing, collections, claims, and preauthorization/approval management.
• Ensure full alignment with insurance company policies, service coverage rules, exclusions, and preauthorization criteria.
• Supervise the approvals unit, ensuring timely submission of pre-approvals for inpatient admissions, surgeries, diagnostics, and high-cost medications.
• Oversee medical coding accuracy and DRG alignment, ensuring claims meet payer standards for maximum reimbursement.
• Coordinate with UHIA and private insurance payers to secure approvals and resolve delays or rejections.
• Develop and implement strategies to reduce denials, increase reimbursement rates, and optimize financial performance.
• Analyze revenue cycle metrics to identify trends, bottlenecks, and areas for process improvement.
• Ensure compliance with healthcare regulations and standards related to financial and billing operations.
• Collaborate with clinical and administrative departments to streamline operations and improve efficiency.

Medical Reviewer at Sharm El Sheikh International Hospital (2024-01 – 2024-08)

• Review and analyze patient medical records to ensure accuracy and compliance with regulatory standards.
• Assess the quality of medical documentation and recommend improvements to enhance clinical and financial outcomes.
• Collaborate with other departments to clarify and resolve documentation issues and ensure proper coding and billing practices.
• Conduct audits to identify discrepancies and provide feedback to improve documentation practices.

Hospital Pharmacist at Aga Health Administration, Ministry of Health (2012 – 2023-12)

• Dispense medications accurately and safely, ensuring proper dosages and administration instructions.
• Manage inventory of pharmaceuticals, including ordering, storage, and ensuring the proper handling of medications.
• Ensure compliance with hospital policies and regulatory requirements related to medication management.

MBA in Hospital Management – Arab Academy for Science, Technology and Maritime Transport (2023-08)

Bachelor of Pharmaceutical Science in Pharmaceutical Science – October 6 University (2010-09)