Medical Claims Operations

To ensure that assigned provider’s Inpatient and Outpatient claims are medically & commercially adjudicated within the specified timeframe and within the targeted quality to achieve the business objective of ensuring that BUPA delivers high quality claim statements. Adjudication - Process all the daily batches of claims assigned in line with medical...

MedNet is one of the leading managed care service organizations that caters to healthcare needs and offers protection against unforeseen health risks. We are looking for a Claims Manager who will plan and manage the data entry and claims processing operations of the assigned MedNet in order to ensure the delivery of superior claims handling services to...

Job Summary:We are seeking a highly skilled Claims Manager to oversee our data entry and claims processing operations.The successful candidate will be responsible for planning and managing the overall claims processing operations, ensuring prompt services to clients, and supporting the achievement of MedNet Saudi Arabia's goals and objectives.Key...

About Us:MedNet is one of the leading managed care service organizations that caters to healthcare needs and offers protection against unforeseen health risks.We are looking for a Claims Manager who will plan and manage the data entry and claims processing operations to ensure the delivery of superior claims handling services to customers within the defined...

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...

About the RoleThe Senior Specialist will be responsible for guiding the effective and accurate assessment, administration, and fair settlement of valid claims submitted by customers. This role will also provide support to the Head, Claims and Recovery in all recovery operations.Key ResponsibilitiesComplies with guidelines and leads the collection of relevant...

Job DescriptionThe Islamic Development Bank is seeking a highly skilled Senior Specialist to join its team in the Claims and Recovery department. This role requires strong analytical, communication, and problem-solving skills to effectively assess and settle claims submitted by customers.Main ResponsibilitiesLead the investigation of claims submitted by...

About the PositionThis position is responsible for guiding the effective and accurate assessment, administration, and fair settlement of valid claims submitted by customers. The Senior Specialist will provide support to the Head, Claims and Recovery in all recovery operations.Key ResponsibilitiesGuides the investigation of claims submitted by customers to...

Job SummaryThe Islamic Development Bank seeks a Senior Specialist to manage claims and recoveries operations in the Legal Affairs Department. The successful candidate will have a strong background in insurance, economics, finance, law, or business administration and excellent analytical, communication, and problem-solving skills.Main ResponsibilitiesLeads...

Role Purpose: Perform medical analysis and the inflation drivers from medical point of view, along with underwriting and pricing cases. Key Accountabilities: 1- Medical Underwriting; - Estimate cost of the medical conditions declared under the retail products based on medical reports and test results submitted by the member for new retail business. -...

Is responsible for overseeing the RCM operations including claims and billing management. Communicate partner providers, implement and refine processes of audit and compliance, execute special RCM projects and participate in different analytical activities **Claims and billing management** - Develop and maintain a strategic approach to the revenue cycle...

Andalusia Group of Medical services is hiring " Centers insurance manager" in KSA, Jeddah. - A strong previous experience in Insurance - Experience in (Approvals-Claims-RCM ) Departments. - Any nationality

Develop and manage the excellence deployment for all payer operation and claim requirements in line with regulator policies and ensure proper collaboration with Nahdi departments to ensure the best outcomes via established SLA & SOPs. **Accountabilities** **Contracting & Benefit File Excellence**: - Ongoing maintenance of all payers contract to comply...

Job Description:As a Claims Manager, you will play a crucial role in ensuring the smooth operation of our claims processing system.You will be responsible for settling claims, maintaining reserves, and acting as an external auditor for claims above a defined level.In addition, you will maintain close rapport with major clients, act as the contact person for...

Senior Intensivist PositionWe seek a highly skilled Senior Intensivist to lead our ICU team in Jeddah. As a senior member of our team, you will be responsible for providing expert care to critically ill patients, mentoring junior staff, and driving clinical excellence.Key ResponsibilitiesDeliver high-quality patient care, including diagnosis and treatment of...

Job Title: Medical Sales Operations Executive">We are seeking an experienced Medical Sales Operations Executive to join our team in Saudi Arabia. The ideal candidate will have a proven track record of managing sales operations, analyzing market trends, and delivering business results.">About Our Company:">Johnson & Johnson is a multinational healthcare...

Key ResponsibilitiesThe Senior Specialist in Insurance Operations will be responsible for coordinating all matters related to legal procedures involved in cases of claim settlement and recovery process as and when required. This includes providing inputs to underwriters on review of potential or existing insured claim experience, and working closely with...

About the RoleThis Senior Claims Examiner position at IsDB Group involves providing technical guidance on claims and recovery to legal counsels, advising and assisting client departments in structuring projects, finance, and investment transactions. The role also entails preparing technical opinions as requested by management, coordinating and...

We're searching for a Medical Services Operations Manager to join Saudi German Health Careers KSA in Jeddah. As our Patient Experience Manager, you'll empower our team to deliver world-class experiences with compassion and professionalism.**Responsibilities:**Train and inspire staff to deliver exceptional patient experiencesIdentify opportunities to enhance...

Andalusia group of medical services is hiring " Sales operation manager" in KSA, Jeddah. - Saudi Nationality only - Jeddah Residents only - IFCE holder is preferred - Must have Customer Wallet