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Esraa Eid

Esraa Eid

Medical Claims Specialist | Clinical Pharmacist

كفاءة
Qalyūbعضو منذ ١٤ أغسطس ٢٠٢٦
Medical Claims ReviewInsurance Eligibility & Coverage VerificationPrescription ReviewClaims Documentation & SubmissionApproved/Rejected Claims ReviewLimits & ExclusionsClaim Rejection InvestigationMedication SafetyDocumentationMicrosoft OfficeCommunicationTeamworkProblem Solving
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أرسل عرض عمل مباشرة لهذا المرشح

Medical Claims ReviewInsurance Eligibility & Coverage VerificationPrescription ReviewClaims Documentation & SubmissionApproved/Rejected Claims Review

نبذة

Pharmacist with hands-on experience in medical insurance claims, prescription review, insurance eligibility and coverage verification, claims documentation, and approved/rejected claim review. Experienced in checking limits and exclusions, investigating claim rejection reasons, and supporting accurate prescription processing in line with insurance requirements. Clinical pharmacy and hospital experience provide a strong medical and pharmaceutical foundation for Medical Claims roles.

الخبرة

Clinical Pharmacist at Qalyub Hospital (2024-08 – Present)

  • Provide evidence-based medication recommendations and collaborate with healthcare teams.
  • Maintain accurate documentation and support compliance with clinical and medication-related requirements.
  • Maintain current therapeutic knowledge to support safe and appropriate medication use.

Part-Time Community Pharmacist at Mohamed & Essam Pharmacy, Downtown (2025-02 – Present)

Working as a part-time community pharmacist, providing pharmacy services and patient care in a community pharmacy setting.

Community Pharmacist at Dr. Ahmed Hussein Harhash Pharmacy (2022-01 – 2025-01)

  • Reviewed prescriptions before dispensing to verify insurance coverage and patient eligibility.
  • Checked insurance limits and exclusions before prescription processing.
  • Reviewed approved and rejected medical insurance claims and investigated reasons for claim rejection.
  • Prepared and maintained claims-related documentation and submissions.
  • Processed approximately 15 medical insurance claims daily with a focus on accuracy and compliance.
  • Handled claims associated with Nice Deer, Globe Med, Wadi El Nile, and MedNet.
  • Ensured accurate prescription processing in accordance with applicable insurance requirements.
  • Provided patient counseling, drug interaction education, and OTC recommendations.

Inpatient Pharmacist (2023-03 – 2024-05)

Worked as an inpatient pharmacist during this period.

Pharmacy Trainee at Dalia Ezzat Pharmacy (2018 – 2019)

  • Community pharmacy training and dispensing.

التعليم

Bachelor of Pharmacy in Pharmacy – Ain Shams University, Faculty of Pharmacy (2020-08)

المهارات

Medical Claims SpecialistClinical Pharmacist

التقييمات