mohand Elgaafary
@mohandelgaafary
Detail-oriented medical billing specialist with expertise in claims resolution and eligibility verification.
What I'm looking for
I am a results-driven Medical Billing Specialist with hands-on experience in A/R follow-up, claim denial resolution, and insurance eligibility verification.
I have routinely processed and followed up on high-volume claims using portals such as Availity and Navinet, averaging 30 claims per day while maintaining HIPAA compliance and accurate documentation.
My background includes improving workflows and implementing new systems in IT and operations roles, training new staff on payer portals and verification procedures, and driving measurable improvements in accuracy and efficiency.
I bring strong communication skills in English and Arabic, a proven ability to work independently and cross-functionally, and a commitment to reducing denials and maximizing reimbursement.
Experience
Work history, roles, and key accomplishments
Medical Billing Specialist
PWE Medical Billing
Jan 2024 - Present (1 year 9 months)
Manage A/R follow-up and claim denial resolution, processing an average of 30 claims/day and appealing denied or underpaid claims to expedite payments and recover revenue. Analyzed denial trends, corrected billing errors, and provided reporting to revenue cycle management while ensuring HIPAA compliance.
Call Center Agent
Al Basha Restaurant
Jan 2023 - Dec 2023 (11 months)
Handled customer orders and reservations with 98% accuracy, reduced average call duration by 15%, and supported promotional campaigns that increased promoted-item sales by 20%. Consistently maintained over 99% attendance and improved average order value through upselling.
Interior Designer
Archivers Design Studio
Jan 2021 - Dec 2023 (2 years 11 months)
Completed over 25 residential and commercial projects on time and within budget, delivering innovative design solutions and improving project management processes to reduce average completion time.
IT Technician
Archivers Design Studio
Jan 2021 - Dec 2023 (2 years 11 months)
Implemented a task management system and led software deployments and a cloud migration, improving collaboration and reducing system failures via proactive maintenance. Created an Excel-based budget tracker that increased financial tracking accuracy by 30%.
Eligibility Specialist
PWE Medical Billing
Verified insurance eligibility and benefits across Medicare, Medicaid and private payers using payer portals and direct communication, reducing rejected claims through proactive corrections and staff training. Maintained payer policy knowledge and ensured compliant handling of patient data.
Education
Degrees, certifications, and relevant coursework
Nile Academy For Engineering
Architectural Engineering
2021 -
Studied Architectural Engineering with coursework and training completed beginning July 2021.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
Skills
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