Senior Claim Specialist
Ninja
RiyadhFull-time
2–7 years of experience
3 months ago
Job description
Review and process insurance claims and e-claims submissions.
- Analyze claim rejections and coordinate resubmissions with supporting documentation.
- Ensure compliance with Nphies standards and CCHI regulations.
- Monitor claim payments, reconciliations, and collection reports.
- Prepare periodic reports on submissions, rejection trends, and recovery rates.
- Coordinate with internal teams and insurance stakeholders to resolve claim issues.
Requirements
- Bachelor s degree in Insurance or related field.
- Minimum 2 years of experience in insurance claims processing.
- Previous experience in a pharmacy chain is required.
- Knowledge of Nphies platform, ICD-10 AM coding, and insurance regulations.
- Strong analytical and communication skills.