Medical Approval Specialist

1 week ago


Riyadh, Ar Riyāḑ, Saudi Arabia Boundless Drop Full time
Medical Approval Officer Role

Boundless Drop is seeking a highly skilled Medical Approval Officer to join our team in Riyadh, KSA.

Key Responsibilities:
  1. Medical Provider Relations: Establish and maintain strong relationships with medical providers, negotiating discounts, reviewing price lists, and conducting regular site visits.
  2. Prior-Approval Requests: Analyze and negotiate prior-approval requests with medical providers, approving cases when agreements are reached, and entering claims into the insurance system.
  3. In-Patient Claims Supervision: Supervise in-patient claims, including on-site visits during hospitalization, to ensure accurate and timely processing.
  4. Medical Advisory Services: Provide expert advice on medical basics and practices to support informed decision-making.
  5. Claim Processing Support: Assist medical claims administrators in processing claims, ensuring accuracy and efficiency.
  6. Medical Claim Validation: Validate all medical claims in the insurance system to ensure compliance with regulations and company policies.
  7. Client Communication: Communicate with insured members regarding claims and requests, providing clear and concise information.
  8. Training and Development: Design and deliver training seminars on insurance medical products to clients, prospects, and internal sales teams.
  9. Confidentiality: Maintain the confidentiality of all medical information, adhering to strict data protection protocols.

Boundless Drop is committed to providing a supportive and dynamic work environment. If you are a motivated and detail-oriented professional with a passion for healthcare, we encourage you to apply for this exciting opportunity.



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