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Medical Claims

1.00 to 10.00 Years   Khobar, Saudi Arabia   25 Feb, 2025
Walaa Cooperative Insurance Company
100 to 499 Jobs Openings
Job LocationKhobar, Saudi Arabia
EducationNot Mentioned
SalaryNot Mentioned
IndustryInsurance & TPA
Functional AreaNot Mentioned

Job Description

Key Responsibilities

  • Process outpatient claims daily in adherence to medical policies and guidelines.
  • Review claims data (physical and electronic) to ensure accuracy and compliance with operational checklists.
  • Maintain accuracy rate in quality audits and meet daily processing targets.
  • Identify unusual provider patterns and escalate potential fraud to the Supervisor of Medical Claims and Special Investigations Unit (SIU).
  • Collaborate with senior staff on complex claims cases to ensure sound medical decisions.
Qualifications Education:
  • Bachelor?s degree in Dental, Physiotherapy, Pharmacy, or a related medical field.
Experience:
  • A minimum of 2 years in health insurance is preferred.
  • Fresh graduates with relevant educational backgrounds are encouraged to apply.

Keyskills :

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