Medical Insurance

2 weeks ago

المملكة العربية السعودية, Saudi Arabia Nahdi Full time

Establish, Leading and developing the Medical Insurance Business strategy, corporate sales function to sign credit sales deals and Revenue Cycle Management (RCM) to achieve 80% revenue of group of polyclinic by representing company negotiating and signing insurance contracts and expansions of network to ensure achieving the business targets for the organization.


Minimize the rejections of claims to the mínimal to achieve profitability by setting right system of claiming and billing, handling the complaints from the medical insurance patients and managing the approval and revenue realization from the medical insurance channel of business.

Building strategic partnership with insurance and big accounts companies as commercial representative of the Nahdi care clinics.

Accountabilities

  • Plan, develop and manage strategy for 80% of clinic revenue by scanning business opportunities with insurance and corporate sales the relationship to ensure drawing good volume of business.
  • Ensure achieving the planned financial target for the organization and enhancing the portfolio of services offered for the medical insurance patients.
  • Develop the network of medical insurance providers that the organization is dealing with to ensure the achievement of the business targets.
  • Draft, pass for approval, review and execute all the contracts of the medical insurance providers to ensure that the clinic is efficiently managing the relation with them and ensure the regular cash flow.
  • Responsible for the claim preparation, submission and follow up on time to avoid any loss of revenue.
  • Analyze, review and supervise to ensure the proper reconciliation of accounts with the medical insurance providers on time.
  • Submission of prior approvals inline with CCHI regulations and guide line to avoid any possible penalties or loss of revenue.
  • Work on promoting and marketing the business by developing the communications with the concerned parties and organizing such as health events in headquarters and big malls to increase the attraction to the clinics and build good relationships.
  • Develop and deliver an effective training for the reception, call center and medical staff about the different insurance coverages offered and supported by the clinic so they can handle all the questions from the patients and customers.
  • Respond and act as an escalation line for all issues or complaints related to the insurance patients and have to make sure of solving all the complaints within the agreed time frame.
  • Submit recommendations related to enhancing the services offered to the insurance patients for the top management's approval
  • Support and contribute in the budget planning and forecasting exercise for the clinic.
  • Handle and settle all the claim disputes.
  • Ensure performance management and coaching procedures are applied to his team to allow proper and objective judgment and decisions related to the organization's employees.
  • Support and collaborate with HR the effective and proper learning and development for his team.
The employee's duties are not limited to the above-mentioned accountabilities. The manager can assign other duties based on the business need.

Work Environment

  • Indoors : 70%
  • Outdoors : 30%
  • Working Days : 6 Working Days
  • Days off : 1 Days Off
  • Working Hours : (8 or 9) AM to (5 or 6) PM with 1 hour break (flexible working hours)

Job Requirement
**Education

  • Qualified Medical Doctor or Pharmacist.**Experience
  • 5 years in Sales and Medical insurance role.**Computer Skills
  • Microsoft Office**Languages
  • English and Arabic (fluent speaking and writing)

  • Medical Insurance Senior Specialist

    4 weeks ago

    المملكة العربية السعودية, Saudi Arabia Nahdi Full time

    This role will be leading and managing the medical approvals, insurance claiming and Billing process with insurance companies and credit corporate sales accounts. Also working to minimize the rejections and collect payments within due dates to improve polyclinic profitability. **Accountabilities** - Medical Insurance Head Working on instant approvals for...

  • Medical Insurance Senior Specialist

    4 weeks ago

    المملكة العربية السعودية, Saudi Arabia Nahdi Full time

    This role will be leading and managing the medical approvals, insurance claiming and Billing process with insurance companies and credit corporate sales accounts. Also working to minimize the rejections and collect payments within due dates to improve polyclinic profitability. **Accountabilities** - Medical Insurance Head Working on instant approvals for...

  • Medical Insurance

    5 days ago

    المملكة العربية السعودية, Saudi Arabia Nahdi Full time

    Establish, Leading and developing the Medical Insurance Business strategy, corporate sales function to sign credit sales deals and Revenue Cycle Management (RCM) to achieve 80% revenue of group of polyclinic by representing company negotiating and signing insurance contracts and expansions of network to ensure achieving the business targets for the...

  • Medical Representative

    2 weeks ago

    المملكة العربية السعودية, Saudi Arabia TASC Outsourcing Full time

    -المملكة العربية السعوديةApr 6, 2023SAR SAR 8000PermanentFull timeOur client is a Pharmaceutical Manufacturing company. They are now looking for a Medical Representative to join them.Roles & Responsibilities- arrange appointments with doctors, pharmacists and hospital medical teams, which may include pre-arranged appointments or regular...

  • Medical Doctor

    2 weeks ago

    المملكة العربية السعودية, Saudi Arabia Bupa Arabia Full time

    In this role you will support Bupa to ensure medical spend (In-Patient & Out-Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical standards, safeguarding the member's health & safety and aligned to BUPA Values.You will be responsible for the...

  • Senior Nuclear Insurance Specialist

    3 weeks ago

    المملكة العربية السعودية, Saudi Arabia Jacobs Full time

    Challenging Today. Reinventing Tomorrow. - We're invested in you and your success. Everything we do is more than just a project. It's our challenge as human beings, too. That's why we bring a thoughtful and collaborative approach to every one of our partnerships._ - At Jacobs, we challenge the status quo and redefine how to solve the world's greatest...

  • Medical Secretary

    4 weeks ago

    المملكة العربية السعودية, Saudi Arabia AlBorg Diagnostics Full time

    Al Borg Diagnostics, a leading provider of diagnostic health services, is seeking a dedicated and detail-oriented Medical Secretary to join our team. As a Medical Secretary, you will play a crucial role in providing administrative support to our medical staff and ensuring the smooth operations of our clinic. Your main responsibilities will include managing...

  • Medical Doctor

    2 months ago

    المملكة العربية السعودية, Saudi Arabia Bupa Arabia Full time

    In this role you will support Bupa to ensure medical spend (In-Patient & Out-Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical standards, safeguarding the member's health & safety and aligned to BUPA Values.You will be responsible for the...

  • Medical Doctor

    3 months ago

    المملكة العربية السعودية, Saudi Arabia Bupa Arabia Full time

    In this role you will support Bupa to ensure medical spend (In-Patient & Out-Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical standards, safeguarding the member's health & safety and aligned to BUPA Values. You will be responsible for the...

  • Specialized Medical Doctor

    2 months ago

    المملكة العربية السعودية, Saudi Arabia Bupa Arabia Full time

    In this role you will support Bupa to ensure medical spend (In-Patient & Out-Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical standards, safeguarding the member's health & safety and aligned to BUPA Values. You will be responsible for the...

  • Medical Director

    3 weeks ago

    المملكة العربية السعودية, Saudi Arabia Alert HR Solutions Full time

    **Introduction**: Our client is a rehabilitation and long-term care provider, with facilities in UAE and now their first clinic in Saudi Arabia! They provide multidiscipline medical care and rehabilitation services to adults and children. The facility provides treatment and care for patients requiring short-term comprehensive rehabilitation or inpatient...

  • Medical Director

    2 weeks ago

    المملكة العربية السعودية, Saudi Arabia Alert HR Solutions Full time

    Introduction: Our client is a rehabilitation and long-term care provider, with facilities in UAE and now their first clinic in Saudi Arabia They provide multidiscipline medical care and rehabilitation services to adults and children. The facility provides treatment and care for patients requiring short-term comprehensive rehabilitation or inpatient medical...

  • Pharmaceutical Medical Representatives

    2 weeks ago

    المملكة العربية السعودية, Saudi Arabia Qureos Inc Full time

    **Job Title**: Medical Representative (Pharmaceutical Manufacturing Industry) **Company**: Alpha Pharma **Location**: 3289 - Industrial Valley Phase II, King Abdulaziz Economic City 23994 - 8711, Rabigh KSA **Employment Type**: Full-time Alpha Pharma, a leading pharmaceutical company committed to providing innovative and high-quality healthcare products,...

  • Medical Doctor

    3 months ago

    المملكة العربية السعودية, Saudi Arabia Talent Pal Full time

    **Pre-Authorization** In this role you will support Bupa to ensure medical spend (In-Patient & Out-Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical standards, safeguarding the member's health & safety and aligned to BUPA Values. You will be...

  • Chief Health Officer

    2 months ago

    المملكة العربية السعودية, Saudi Arabia B7 Consultancy Full time

    REPORTS TO**:CEO** | TEAM SIZE**:96 ( 4 Direct report, 92 indirect)** **JOB PURPOSE**: To lead the development and implementation of the strategic plans and operational objectives of the Health and Life claim business unit. Ensuring operational integrity and compliance with quality standards and applicable regulations and legislation across claims...

  • Associate - Claims Preparation & (Re) Submission

    3 weeks ago

    المملكة العربية السعودية, Saudi Arabia Sawaid Full time

    **We are looking for a **" Associate - Claims Preparation & (Re) Submission "** to join a **Supportive Healthcare And Health Insurance** company in Saudi Arabia.**: **The location work in Riyadh.** **What your **Responsibilities**: - All services provided to insured patients must be prepared in a defined claim format in order to reimburse incurred costs...

  • Associate - Claims Preparation & (Re) Submission

    2 weeks ago

    المملكة العربية السعودية, Saudi Arabia Sawaid Full time

    We are looking for a " Associate - Claims Preparation & (Re) Submission " to join a Supportive Healthcare And Health Insurance company in Saudi Arabia:The location work in Riyadh.What your Responsibilities**: All services provided to insured patients must be prepared in a defined claim format in order to reimburse incurred costs from the insurance companies....

  • Consultant Maternal Fetal Medicine

    2 months ago

    المملكة العربية السعودية, Saudi Arabia Davidson Management Consultants Full time

    *** **Salary : SAR 80,000 plus medical insurance and annual air tickets.** *** Status: **Open

  • Consultant Maternal Fetal Medicine

    1 day ago

    المملكة العربية السعودية, Saudi Arabia Davidson Management Consultants Full time

    *** **Salary : SAR 80,000 plus medical insurance and annual air tickets.** *** Status: **Open

  • Emergency Medicine

    4 weeks ago

    المملكة العربية السعودية, Saudi Arabia Search PLUSHR Full time

    Looking for an Emergency Room (ER) Doctor, you will supervise the functioning of the Emergency Department (ED), from arrival to admission/discharge of patients, according to the objectives of the project, and in collaboration with the other hospital departments. You will be responsible for providing the best medical care to patients and will be involved in...