Specialist, Medical Insurance Administration III
Ma
2–7 years of experience
Manage and administer employee medical insurance services, work injury processes, and healthcare coordination activities while ensuring compliance with regulatory requirements and company policies. The role supports employees medical needs through effective insurance administration, claims management, healthcare provider coordination, and occupational health compliance.
Key Accountabilities
Administer employee medical insurance programs in compliance with Health Insurance Council (CHI) regulations.
Coordinate insurance approvals, coverage inquiries, escalations, and monitoring of medical coverage limits.
Review, validate, and process employee medical expense claims in accordance with company policies.
Manage GOSI registration, reporting, and follow-up for all work-related injury cases.
Coordinate pre-employment medical examinations for new hires.
Maintain accurate medical insurance and employee healthcare records.
Support employees with medical insurance inquiries and healthcare service requirements.
Ensure quality and effectiveness of healthcare providers, including company clinics and external medical facilities.
Conduct site visits to hospitals and medical facilities to monitor service quality and compliance with approved healthcare standards.
Coordinate medical travel arrangements for employees requiring specialized treatment within and outside the Kingdom.
Minimum Qualifications Bachelor s degree in healthcare administration, Business Administration, Human Resources, or a related field.
Minimum Experience Minimum 2 years of experience in medical insurance administration, healthcare services, employee medical support, or a related healthcare field.
Skills Knowledge of Health Insurance Council (CHI) Regulations GOSI Platform Management Patient Service Experience and Employee Medical Support Knowledge of Medical Terminology Medical Insurance Coordination and Provider Management Hospital and Healthcare Industry Experience Microsoft Office (Excel, Word, PowerPoint, Outlook) Strong Communication and Stakeholder Management Skills Analytical Thinking and Problem Solving Time Management, Planning, and Organization English Language Proficiency
Competencies Teamwork Integrity Care Ownership Communication Accountability Customer Focus Analytical Thinking Problem Solving Planning and Organizing Service Excellence