Open to opportunities

Georgina Michel

@georginamichel

Message

Insurance claims and audit leader improving payer acceptance through coding accuracy and process control.

Egypt

Message

What I'm looking for

I’m looking to grow in healthcare insurance claims leadership—driving accurate coding and payer-compliant submissions, reducing avoidable rejections, and improving acceptance rates through strong cross-team coordination and continuous process improvement.

I’m an insurance claims professional with a pharmacy background, currently serving as Deputy of Insurance Manager at Al-Modawat Specialized hospital in KSA. I conduct systematic reviews and audits of insurance claims to protect data integrity and documentation sufficiency, ensuring alignment with payer policies before submission.

I also strengthen insurance mapping and contracting activities, monitor claim outcomes, and analyze rejections to drive timely corrections and resubmissions. Previously, as a Claims Senior Specialist and Claims Specialist at Saudi German hospital, I oversaw day-to-day claims operations, reviewed rejected claims for resubmission eligibility, maintained precise records, and guided new team members—building a reputation for accuracy, compliance, and faster collection cycles.

Experience

Work history, roles, and key accomplishments

Current

Deputy of Insurance Manager

Current

Al-Modawat Specialized Hospital

Jan 2025 - Present (1 year 6 months)

Conducts audits and systematic reviews of insurance claims to ensure data integrity and payer-policy adherence prior to submission. Manages insurance mapping/contracting support, rejection analysis, and post-submission follow-up to improve acceptance rates.

Insurance Mapping Contracting Claim Rejections Attachment Handling Authorization Reference Checks Eligibility Benefit Mismatch Correction

Claims Senior Specialist

Saudi German Hospital

Jan 2024 - Dec 2024 (11 months)

Oversees day-to-day claims department operations, including supervising specialists, assigning tasks, and following up with payers. Ensures claims are processed accurately and timely, reviews rejections for resubmission eligibility, and maintains detailed claim and payment records.

Claims Processing Payer Follow Up Cross Functional Coordination (Approvals Pricing Profiling Contracting Medical Records)Claims Volume Monitoring Claim Rejections Record keeping team training