Job Description

Job Responsibilities:

Develop and implement insurance policies and procedures. Manage relationships with insurance providers and brokers. Oversee claims processing and approval workflows. Assess risks and recommend appropriate coverage. Ensure compliance with legal and regulatory requirements. Monitor insurance expenses and optimize cost-efficiency. Provide reports and analysis on insurance claims and coverage Provide overall supervision of all medical insurance sections (Approvals, Claims, Medical Audit, Insurance Accounting) and ensure alignment between them to meet institutional objectives. Establish and update policies and procedures governing insurance operations in accordance with regulatory changes and market dynamics. Monitor key performance indicators (KPIs) across all reporting departments and ensure targets are being met (e.g., approval turnaround, rejection reduction, error minimization, faster claims processing). Review and approve periodic reports submitted by section heads and the insurance accountant, and take appropriate strategic decisions based on insights. Ensure full compliance with Saudi Council of Health Insurance (CHI) regulations and the implementation of official standards and procedures. Submit comprehensive reports to senior management outlining department performance, challenges, recommendations, and status of claims and settlements. Approve insurance contracts and review their terms in coordination with legal and financial departments, while ensuring proper archiving and contract validity tracking. Follow up on overdue settlements with insurance companies and approve follow-up and financial reconciliation procedures. Lead regular meetings with section heads and coordinators to review performance, resolve issues, and identify improvement opportunities. Represent the department in meetings with insurance companies and regulatory bodies as needed.
Job Types: Full-time, Contract
Contract length: 24 months

Application Question(s):

We prefer a General Practitioner doctor for this position with Insurance experience. Do you have a valid License as a GP Doctor?
Experience:

* Insurance: 5 years (Preferred)