H&B Claims Executive
WTW
Date: 13 hours ago
City: Al Khobar
Contract type: Full time
Description
Managing and processing medical insurance claims, ensuring accuracy, compliance, and timely resolution. This role involves reviewing claim documentation, coordinating with healthcare providers and insurers and addressing client inquiries to deliver efficient and effective claim management.
The Role
Client Service & Day to Day Operations
The Requirements
Managing and processing medical insurance claims, ensuring accuracy, compliance, and timely resolution. This role involves reviewing claim documentation, coordinating with healthcare providers and insurers and addressing client inquiries to deliver efficient and effective claim management.
The Role
Client Service & Day to Day Operations
- Accurately review, validate, process and adjudicate medical claims in line with policy terms and company procedures
- Ensure (TAT) turnaround time & delivery to clients
- Communicate with policyholders, healthcare providers, and insurers to resolve claims-related queries
- Provide clear and timely updates on claim status to clients
- Educate clients on policy coverage, exclusions, claims process and requirements
- Prepare and submit reports on claim resolutions and outstanding issues
- Investigate discrepancies and irregularities in claims
- Handle disputes and resolve issues
- Collaborate with Senior Claims Manager for specialized cases
- Maintain detailed and organized records of claim activities
- Implement control procedures
- Ensure implementation of WTW standards
- Follow WTW process and responsible for own results
- Serve as appoint of contact for queries from clients, insurers and internal teams
- Collaborate with departments and maintain process efficiency
- Build successful relationships with employees, clients and insurers
- Implement process quality within the turnaround time
- Identify areas to enhance the process
- Embed and promote a continued improvement environment
The Requirements
- Postsecondary education
- IFCE certification
- Min. 2 years working experience at similar role
- Excellent proficiency in both English and Arabic
- Proficiency in Microsoft Office (Excel, Word, PowerPoint).
- Client-oriented, innovative and critical sense
- Problem-solving and solution-oriented
- Good presentation and negotiation skill
How to apply
To apply for this job you need to authorize on our website. If you don't have an account yet, please register.
Post a resumeSimilar jobs
Early Career Trainee - Control Services
GE Vernova,
Al Khobar
2 days ago
Job Description SummaryThe Early Career Training is a 6-12 months program and it is an investment in young talents where GE Vernova trains fresh graduates who meet the required criteria to perform their traineeship in a GE Vernova business. The traineeship duration varies upon business requirement and will develop the general skills of the trainee and provide on the job...
Chief Financial Officer (CFO001)
Foreground.,
Al Khobar
1 week ago
Foreground is partnering with a prominent infrastructure investment and development group in the Kingdom of Saudi Arabia to identify a seasoned Chief Financial Officer to lead the full financial function of a Special Purpose Vehicle (SPV) established to deliver a major capital project. The appointed CFO will report directly to the CEO and Board of Directors, acting as the financial...
Quality Inspector (m/w/d) Installation Works
ENERCON,
Al Khobar
1 week ago
ENERCON gehört seit mehr als 40 Jahren zu den Technologieführern im Bereich der Windenergie. Als erster Hersteller von Windenergieanlagen setzte das Unternehmen ein getriebeloses Antriebskonzept ein, das ein Merkmal aller ENERCON Windenergieanlagen ist. Auch in anderen Bereichen wie z. B. Rotorblattdesign, Steuerungstechnik und Netzanschlusstechnik ist ENERCON führend und beweist mit einer Vielzahl von technologischen Neuentwicklungen immer wieder seine Innovationskraft.Quality Inspector...
