Medical Approval Officer

6 days ago


Riyadh, Ar Riyāḑ, Saudi Arabia Tabukpharmaceuticals Full time

Job Summary:

Tabukpharmaceuticals is seeking a highly skilled Medical Approval Officer to join our team in Riyadh. As a Medical Approval Officer, you will be responsible for handling relations with medical providers, analyzing prior-approval requests, and supervising in-patient claims.

Key Responsibilities:

  1. Medical Provider Relations: Negotiate discounts, study price lists, handle reconciliations, and visit medical providers regularly.
  2. Prior-Approval Requests: Analyze requests, negotiate cases with medical providers, approve cases when agreements are reached, and enter claims into the insurance system.
  3. In-Patient Claims: Supervise claims, visit patients during hospitalization, and ensure accurate processing.
  4. Medical Basics and Practice: Advise on medical basics and practice, and provide guidance to medical claims administrators.
  5. Medical Claims Administration: Assist in processing claims, validate medical claims, and communicate with insured members.
  6. Training and Seminars: Drive training and information seminars on insurance medical products for clients, prospects, and internal sales forces.
  7. Confidentiality: Ensure that all medical information is kept confidential.

Requirements:

MBBS degree, excellent communication and negotiation skills, and experience in medical claims administration.



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