Danya Al-Jayousi

• Medical review (justifying medical services)
• Review documentation, utilize clinical guidelines, approve or reject claims
• Technical review (evaluating the claims process)
• Check code accuracy, assess procedure validity, review contract terms, policy compliance
• Financial review (justifying payments)
• Apply agreed discounts, verify patient responsibility, adjust for errors, payment negotiation
• Contacting providers and negotiating payments
• Initiate communication, negotiate fair settlements, resolve disputes
• Finalizing payment and justification
• Explain the total amount, documentation, final review

• Adjusted and audited medical claims according to medical guidelines

• Adjusted and audited medical claims according to medical guidelines.

worked about 1 year in a main Pharmacy dispensed prescription medications accurately, adhering to legal and safety protocols optimize patient health outcomes.

Improved patient safety by reducing adverse reactions through detailed medication interaction education.

Maintained appropriate drug records and completed reports as necessary.