معاذ الحربي
I have spent seven years inside the KSA health insurance ecosystem, most of it on the operational side of the payer: claims, coding, provider contracts, and the data that governs medical cost. My work sits where clinical reality meets financial consequence — translating what happens in a hospital into something an executive committee can price, benchmark, and decide on.
My background is clinical — a physical therapy degree from King Saud University — which is why DRG work made sense to me early. Understanding a case mix is not a spreadsheet exercise; it is reading documentation the way a coder and a clinician both read it. That grounding, combined with financial analytics and formal negotiation training, is still an uncommon combination in this market.
Today I lead operational-excellence programs at Tawuniya, running a team of three across DRG readiness, reconciliation, data governance, and workflow automation, and I am completing an Executive MBA in corporate finance and strategic operations.
AR-DRG grouper methodology, ICD-10-AM / ACHI / ACS coding quality, clinical documentation improvement, and provider onboarding — from first coded claim to steady-state volume.
Cost-inflation analytics, CPM benchmarking, claims and rejection management, medical audit, and the KPI frameworks that make cost drivers visible before they land on a renewal.
Tiering and network optimization across regions, contract and pricing strategy, negotiation, and the performance scorecards that hold both sides of a provider relationship to the same numbers.
DRG-coded claims — national adoption scaled from zero, with 5+ providers onboarded and two onsite alignment workshops driving company-wide rollout.
Inflation exposure surfaced across provider groups through a cost-inflation dashboard now used in executive cost-governance decisions.
Provider tier changes enabled by internal and external CPM benchmarks built across 13 KSA regions, feeding a major network refresh.
Processing time on a manual distribution workflow — from more than two hours a day to ten minutes through automation.
Approval delays removed by re-engineering transfer-approval coordination and urgent-case escalation.
Executive dashboards delivered across DRG, inflation, contracting, reconciliation, and claims — the reporting layer behind day-to-day operational decisions.
Reach out directly — I read everything myself.