Medical Claims Adjudicator

To lead and manage the operations in Regions ensuring and improving the performance, productivity and efficiency of reimbursement unit through the provision of effective methods and strategies Operations - Plan implementation strategy to consistently achieve set targets despite continuous change on the number of received claims VS resource availability -...

**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...

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...

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...

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...

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 Medial cost & Service Management - Adjudicate the cases (In-Patient &...

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...

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...

To manage the commercial and contractual relationship with Bupa network providers to ensure compliance with regulators to deliver business benefits. Reconciliation of the accounts - Analyze and monitor the cost effectiveness of the unit and utilization of provider services for better control. - Plan reconciliation meetings including scheduled meetings,...

**Via Medica International Healthcare** is looking for a **Senior Medical Officer/General Practitioner** to join our team for our upcoming project in **KSA.** **Qualifications**: - MOH License in KSA - MBBS Degree **Responsibilities**: - Inspecting and updating patients' charts. - Diagnosing common ailments such as colds, flu, and diabetes. -...

To manage, execute and complete specific deliverables and activities that ensure the effectiveness of the pharmaceutical projects and activities through providing accurate pharmaceutical information, conducting pharmaceutical analysis and medications’ utilization review, managing the pharmaceutical cases and Govern the PBM. This Governance is important to...

**Job Number** 23127655 **Job Category** Human Resources **Location** Nujuma a Ritz-Carlton Reserve, Ummahat Islands 2-3, Red Sea, Saudi Arabia, Saudi Arabia VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** Assists in carrying out the daily activities of the Human Resource...

**Job Number** 22180084 **Job Category** Human Resources **Location** Courtyard Jubail, Centrally located in Jubail on the Dhahran-Jubail Hwy, Jubail City, Saudi Arabia, Saudi Arabia VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** Assists in carrying out the daily activities of...

**Job Number** 23005750 **Job Category** Human Resources **Location** Le Méridien Riyadh, King Abdullah Ibn Abdulaziz Road Al Woroud District, Riyadh, Saudi Arabia, Saudi Arabia VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** Assists in carrying out the daily activities of the...

**Job Number** 23023251 **Job Category** Human Resources **Location** The St. Regis Red Sea Resort, Zone 6 Ummahat Al Sjyakh North, Red Sea, Saudi Arabia, Saudi Arabia VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** Assists in carrying out the daily activities of the Human...

Coordinates and ensures the effective provision of administrative support within the plant or Business unit Main Tasks 1. Ensure adherence to local laws and regulations in all personnel actions. 2. Conduct investigations of employee complaints, document findings. Analyze situation for potential liability and forward it for legal consultation if...

**Job Number** 22137898 **Job Category** Human Resources **Location** Le Méridien Al Hada, Al Hada Ring Road, Taif, Saudi Arabia, Saudi Arabia VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** As a member of the property Human Resources support staff, he/she works with Human...

**Job Number** 23082882 **Job Category** Human Resources **Location** The Luxury Collection Red Sea (NEOM) Sindalah Island, One Marriott Drive, Red Sea (NEOM), Saudi Arabia, Saudi Arabia VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** The HR Manager directs and works with Human...

**Job Number** 22176586 **Job Category** Human Resources **Location** St. Regis Red Sea Resort, Zone 6 Ummahat AlShyakh North, Red Sea, Saudi Arabia, Saudi Arabia VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** The HR Manager directs and works with Human Resources and...

**Job Number** 23138270 **Job Category** Loss Prevention & Security **Location** The St. Regis Red Sea Resort, Ummahat Island 1, Red Sea, Saudi Arabia, Saudi Arabia VIEW ON MAP **Schedule** Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** Assists the Director of Security in managing security operations...