Claims Specialist or Associate

3 weeks ago


Medina, Saudi Arabia Sawaid Full time

**We are looking for a **" Claims Specialist "** to join a " Supportive Healthcare And Health Insurance" company in Saudi Arabia.**:
**The location work in (Al Madinah)**

**What Will You Do**:

- All services provided to insured patients must be prepared in a defined claim format in order to
- reimburse incurred costs from the insurance companies.
- Responsible for preparing & submitting the monthly claims per the payer’s protocol of billing and claim.
- Claim structure must be completed in all medical, and financial forms and supported by all reports and documents.
- Provides timely reports to relevant stakeholders
- Collect Claim forms, pre-authorization/approvals forms, prescriptions, radiology reports, laboratory reports, and all other medical reports relevant to invoices.
- Batch the claims per insurer and prepare a cover letter for submission.
- Request and follow up on all discharge summaries, operative reports, and medical reports needed for attachment with the claims.
- Attach documents to correlating invoices.
- Prepare a claim report each in the corresponding formats to insurance companies and raise it to the supervisor.
- Coordinates with the claim audit team for medical competency and medical review.

**What are the requirements and qualifications required for the job**:

- Associate's or bachelor's degree in a relevant field, such as insurance or business administration
- Prior experience in claims preparation and submission, insurance or customer service
- Knowledge of insurance policies, regulations, and claim processes
- Excellent verbal and written communication skills
- Strong attention to detail and organizational skills
- Ability to work independently and meet deadlines.
- very good in English
- 2 - 5 experience



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