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Medical Claims Officer

2 months ago


Riyadh, Ar Riyāḑ, Saudi Arabia Shawarmer Food Company LLC. Full time
Medical Claims Officer Job Opportunity

We are seeking a highly skilled Medical Claims Officer to join our team at Shawarmer Food Company LLC. in Riyadh, KSA.

Key Responsibilities:

  1. Process daily batches of claims in line with medical policy and guidelines.
  2. Ensure claims are paid as per eligible benefit and coverage.
  3. Discuss high-profile claims with the claims medical manager.
  4. Monitor medical abuse and refer suspected fraud claims to the Audit team.
  5. Monitor prices and calculation discrepancies and report over-invoiced claims.
  6. Apply medical skills to apply rejections.
  7. Assist with additional tasks as assigned.

Requirements:

  • MBBS degree.
  • Strong medical background and expertise.
  • Excellent analytical and problem-solving skills.
  • Ability to work in a fast-paced environment.

What We Offer:

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