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Medical Claims

- Walaa Cooperative Insurance Company
- Khobar · Saudi Arabia

Today 2025/04/25

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8 Open Positions

Full Time Employee

100-499 Employees · Insurance & TPA

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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.

Skills

Strong analytical, quantitative, and problem-solving skills.
Excellent communication, interpersonal, and organizational abilities.
High level of self-motivation and a proactive approach to challenges.

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Walaa Cooperative Insurance Company

Saudi Arabia

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We take pride in introducing ourselves as one of the leading insurance and reinsurance company in the Kingdom of Saudi Arabia with a fully paid-up capital of SAR 850 million. We have been assigned an (A-) Insurance Financial Strength Rating (IFSR) by S&P Global Ratings and (gcAAA) GCC regional scale financial strength credit rating, both with a 'stable' outlook. Moody’s Investors Service rated Walaa with a financial strength rating of (A3). Headquartered in Al-Khobar - Eastern province, the oil hub of the Kingdom, we serve our clients all over the Kingdom through three regional offices and more than 70 retail offices. نفخر في التعريف بأنفسنا كواحدة من أبرز شركات التأمين وإعادة التأمين في المملكة العربية السعودية برأس مال مدفوع بالكامل بقيمة 850 مليون ريال سعودي. تم تقييمنا من وكالة "ستاندرد أند بورز" للتصنيف الائتماني بتقييم القوة المالية (-A) وعلى تقييم (gcAAA) للقوة المالية بمعايير خليجية مع نظرة مستقبلية مستقرة. كما قيمتنا وكالة التصنيف الإئتماني الدولية موديز بتصنيف القيمة المالية (A3) يقع مقر الشركة الرئيسي في مدينة الخبر - المنطقة الشرقية، مركز صناعة النفط بالمملكة ونخدم عملائنا في جميع أنحاء المملكة من خلال ثلاث مكاتب إقليمية وأكثر من 70 نقطة بيع.

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