Medical Claims Specialist

1 week ago


Riyadh, Ar Riyāḑ, Saudi Arabia Izzat Marji Group Full time
Medical Claims Officer Job Description

We are seeking a highly skilled Medical Claims Officer to join our team at Izzat Marji Group. As a Medical Claims Officer, you will be responsible for processing medical claims in accordance with medical policy and inpatient adjudication guidelines.

Key Responsibilities:

  1. Process daily batches of claims, ensuring timely and accurate payment of eligible benefits and coverage.
  2. Monitor and record medical abuse, referring suspected fraud claims to the Audit and Investigation team.
  3. Apply medical skills and expertise to apply rejections wherever applicable.
  4. Collaborate with the Claims Medical Manager/TL to discuss high-profile/high-value claims.
  5. Assist in additional tasks assigned by the Claims Manager/TL.

Requirements:

  • MBBS degree
  • Strong medical background and knowledge of medical policy and inpatient adjudication guidelines
  • Excellent analytical and problem-solving skills
  • Ability to work in a fast-paced environment

What We Offer:

  • A dynamic and supportive work environment
  • Opportunities for professional growth and development
  • A competitive salary and benefits package

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