Financial Claims Coordinator- PMO

2 weeks ago


Dammam, Eastern Province, Saudi Arabia Eastern Health Cluster Full time

"

  • Serve as the primary point of contact for claimants, clients, and internal stakeholders regarding claim inquiries and resolution.
  • Receive, review, and process financial claims submitted by clients, customers, or third-party entities.
  • Verify the accuracy and completeness of claim documentation and supporting evidence.
  • Analyze claims to determine eligibility, coverage, and appropriate reimbursement amounts.
  • Maintain organized records of all claims, correspondence, and related documentation
  • Generate reports on claim status, trends, and outcomes as required by management or regulatory bodies.
  • Communicate with insurance providers, healthcare professionals, legal counsel, and other relevant parties to gather information and facilitate claim resolution.
  • Collaborate with cross-functional teams such as finance, legal, and customer service to address complex claims issues and ensure timely resolution.
  • Conduct audits and quality checks on claims processing activities to identify errors, discrepancies, or potential fraud.
  • Ensure adherence to company policies, procedures, and regulatory guidelines governing claims processing and reimbursement.
  • Stay updated on changes in regulations, industry standards, and best practices related to financial claims management.
  • Resolve disputes or conflicts related to claim decisions through effective negotiation and problem-solving skills.

"

Skills

Qualification Requirement

"Bachelor's degree in Finance, Accounting, Business Administration, or related field.

Prior experience in claims processing, insurance, finance, or a related industry preferred.

Strong attention to detail and analytical skills.

Proficiency in Microsoft Office Suite and claims management software.

Knowledge of relevant regulations and compliance standards


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