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Job Description
Reconciliation of the accounts
- Set the targets aligned with the overall forecast
- Review the statements of accounts and ensure it's quality before sending to the providers
- Analyse the statement with documentation including the achievable amounts
- Ensure that the reconciliation is conducted on regular basis and in line with the CCHI regulations
Contract management
- Review the existing and renewed contracts to identify and resolve issues that ensure better commercial terms and improve operation
Better commercial terms
- Monitor the compliance of the providers with the agreements on their claims presentation
Communications and trends resolutions
- Identify the unfavourable trends in medical practice of the providers
- Communicate identified issues that improve the providers management to the claims ,relation team and commercial teams.
- Keep continuous relation with other medical team in the business including the hospitals audit doctors
- Attend to members and providers complaints on medical issues
Skills
- logical, analytic, Presentation, assessment and interpretation skills
- communication and negotiation skills.
- Basic to intermediate knowledge of Microsoft Office
- Ability to conduct business in English
Education
Insurance and risk, Laboratory and Pharmacy
Job Details
Preferred Candidate
Bupa Arabia
Bupa Arabia is a healthcare insurance company based in the Kingdom of Saudi Arabia. We are an associate business of Bupa Group, which is a global healthcare company with an international reach that extends across multiple business operations, practices, and resources.
Founded in October 1997, Bupa Arabia was initially established through a partnership between Bupa Global International and Nazer Group, with the key focus to provide health insurance services with high quality and competitive prices, while ensuring a distinctive experience for customers. Bupa Arabia has since evolved into a fully Saudi-owned and operated company. Our transformation from a joint venture into a publicly traded company on the Saudi Stock Exchange occurred in 2008, as we made 40% of our shares available to the public during our Initial Public Offering (IPO).
As a subsidiary of the global Bupa Group, we draw upon international expertise while maintaining a profound understanding of local healthcare requirements and regulations. This allows us to offer comprehensive healthcare insurance solutions tailored to the unique needs of the Saudi Arabian market.
Bupa Arabia prides itself on its commitment to the wellbeing and development of its employees, providing them with the same standard of care, support, and professionalism that it expects to be delivered to its customers.
Our core values shape every aspect of our work and culture:
Commit – Own it with accountability and urgency.
Collaborate – Win together through cross-functional synergy.
Care – Put people first, both employees and customers.
