Claims Operations Excellence

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...

Responsible of securing 80% of clinic revenue as its covered under insurance. Managing claiming and billing process internally and externally with excellence. Performs audits on insurance claims to ensure full governance and compliance on the claiming and billing process and raise internal physicians awareness on CCHI and Insurance provider policy including...

Role Purpose: To be responsible for the commercial and medical management of the portfolio providers in order to resolve the identified trends ,unit cost control and obtain competitive commercial terms and reconciliation outcome within the agreed target forecasting ,timescales and quality standards. Key Accountabilities: 1- Reconciliation of the accounts; -...

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...

Executive DirectorWe are seeking an accomplished leader to join our team at Foreground LLC as an Executive Director for the Transportation Sector. This is a pivotal opportunity for a visionary individual who excels in operational leadership, business growth, and people management.About the RoleThis is a key position within our organization that demands a...

To lead, design, execute and monitor all the strategic and operational activities of the service differentiation to ensure that Bupa Arabia is the preferred insurance company and stays, ahead of competition in every touch point of the customer journey. **Service Excellence Strategy**: - Partner with the Key Stakeholders/Directors in order to design the...

Responsible for overseeing the analysis, design, and implementation of business systems and solutions within the Claims Management department. Business Analysis - Collaborate with stakeholders to understand business requirements and translate them into functional specifications. - Conduct thorough analysis of existing claims management processes,...

Partner with the Key Stakeholders/Directors in order to design the service excellence strategy framework and drive the Service Excellence Strategy Steering Committee through monthly sessions to ensure BUPA service targets are on track. - Ensure that all the Service Differentiation activities agreed, and the service strategy framework are being delivered by...

**Primarily, the Customer Excellence Director - **_member of the Affiliate Leadership Team_**: - guides, monitors, and develops strategies aimed to improve business and planning processes across all brands and departments to add continuous improvement value placing the patient at the center of any efforts and operating within AbbVie business code of...

Job Title:Industrial Service Operations ManagerAbout RecruitMe Plus:We are seeking an experienced Industrial Service Operations Manager to oversee all service operations for industrial equipments, power tools, and garage equipment in Jeddah, KSA.Salary Estimate:$8,000 - $12,000 per monthJob Description:Company Overview:Our client is a leading distributor of...

Job Purpose: Ensure that the service offered is timely, efficient, and professional and of the highest level, as per the criteria set forth by the Companys commercial, safety and security policies, standards and procedures. Supervise and coordinate all internal and external agencies, such as Handling agents, Service Providers, other airlines and various...

Bupa Connected Care Hospitals is a leading healthcare provider committed to delivering exceptional patient-centered services, clinical excellence, and operational governance across a network of hospitals. We believe in providing top-notch medical care and ensuring a positive patient experience at every step of their healthcare journey Patient-Centered...

Promote BA services by supporting members to utilize services (Tebtom, Rahatkom, Telemedicine, etc) and keep members engaged with company services. - Guide members on points of contact for queries and communication. - Update members on insurance coverage details, follow up cases, inquiries and responses with full support. - Complete transactions and...

Jamjoom Pharma has in a very short span of time emerged, as one of the leading pharmaceutical companies in the Afrasia region. The geographical focus of the company is on countries in the Middle East, Africa, and CIS regions. Strategic focus on selected therapeutic categories has contributed to the rapid growth, market acceptance, and overall success of the...

JOB PURPOSE The primary mandate is to assist the Head of Reinsurance with respect to claims and underwriting functions related to reinsurance. The role will assist in the engagement with the Treaty and Facultative market for reinsurance support, calculations of the reinsurance premiums, exposures, claims payments and recoveries, maintenance of reinsurance...

**Job Requirements**: **Job Summary**: The Warranty Administrator will be responsible for managing warranty claims, coordinating repairs, and ensuring compliance with warranty guidelines and procedures. **Job Requirements**: - High school diploma or equivalent; Bachelor’s degree is a plus - Proven experience as a Warranty Administrator or in a similar...

**Function**:Engineering **Reports to**: Transformation Engineering & Manex Assistant Manager **Scope**: Local **Location**: Jeddah, KSA **Terms & Conditions**: Full Time **ABOUT UNILEVER** With 3.4 billion people in over 190 countries using our products every day, Unilever is a business that makes a real impact on the world. Work on brands that are...

The Commercial Manager oversee all contract activity for a Division, a major market segment, or for a major project. Travel to the client’s offices or to the project site may be required, either before the contract receives final approval or during the life of the contract. **What You’ll Be Doing**: - Project start up, implementation of procurement,...

Key responsibilities: - Overseeing and assessing customer service staff activities and providing them with regular performance-related feedback. - Strategizing and monitoring the daily activities of customer service operations, including preparing of customer service team duty rosters, scheduling annual leave for staff etc. - Assisting customer service...

**Company Overview**: Our client is a Saudi retail and E-commerce company working in the field of home furnishings since 1997, they specialize in premium bedding and home accessories in the Saudi market. They import high-quality goods from around the world (Europe, Asia, and the Arab region) and offer a wide variety to meet all customer preferences. Their...