29 D O Insurance jobs in Saudi Arabia

Join My Clinic, the leading multispecialty outpatient care provider in Saudi Arabia, where our mission to help people live longer, healthier, and happier lives drives everything we do. Since 2017, we've been at the forefront of healthcare, combining innovation with a deep commitment to care, collaboration, ambition, and responsibility. As we continue to grow and reach new heights, we're looking for passionate individuals who share our vision and values.

Job Summary:

Insurance Doctor is primarily responsible for utilizing patients' electronic health records to code medical procedures and examine insurance claims. Communicating with insurance companies, updating internal billing databases, electronically storing patients' records, analyzing insurance requests, detecting coding errors, and verifying medical coverage.

Primary Responsibilities:

1. Multisite management on pre-authorization and claims management.
2. Optimizing the revenue, average unit cost and services' utilization.
3. Pre-authorization management and improve the rejection percentage.
4. Guiding and improving pre-authorization team performance.
5. Insurance awareness for the medical team guided by the rejection's loss tree.
6. Following up completing the orders once done by the patients
7. Insurance awareness sessions for the operations staff to discuss the regulations updates.
8. Actively participation in complaints management and executing the corrective actions.
9. Collaboration with the stakeholders concerned to optimize the revenue by reducing the rejections.
10. Perform other professional duties requested from line manager.

Education / Professional Qualifications:

1. Education Degree: M.B.B. Ch
2. Years of Experience: Minimum of 3-5 years
3. License: SCFHS (preferable)
4. Professional Certification: I.F.C.E

Experts & Skills:

1. Excellent Command of oral and written English
2. Good communication skills dealing with both internal and external customers
3. Microsoft knowledge and skills (particularly EXCEL)

Industry Advisor – Insurance Regulatory Project (Riyadh, Saudi Arabia)

Location:
On-site in Riyadh

Contract Length:
12 months (Full-time)

Eligibility:
Must be able to work on-site in Saudi Arabia

About the Role

We are seeking a highly experienced Industry Advisor with deep expertise in the insurance sector to support a major regulatory transformation project in Riyadh. This position is ideal for a seasoned insurance leader—someone at a former CEO, Partner, or senior executive level—who brings over 25 years of industry experience and a strong understanding of regulatory frameworks.

The successful candidate will provide strategic insight and advisory support across multiple insurance domains, working closely with regulatory stakeholders and industry leaders to shape the future of the sector.

Key Responsibilities

• Provide strategic and technical advice on insurance regulation and market practices.
• Support the design and implementation of regulatory and policy frameworks.
• Engage with senior stakeholders across insurance companies and regulators.
• Offer deep sectoral expertise across Life, Property & Casualty, Motor, Health, and Reinsurance.
• Contribute thought leadership on areas such as risk, compliance, finance, and M&A in insurance.

Candidate Profile

• 25+ years of experience in the insurance industry.
• Proven track record as a CEO, Partner, or senior executive within major insurance organizations or advisory firms.
• Strong background in insurance regulation and board advisory.
• Deep expertise across all five domains: Life, P&C, Motor, Health, and Reinsurance.
• Regional experience in Middle Eastern or GCC markets preferred.
• Full-time availability for a 12-month engagement in Riyadh.

Claims Reviewing

• Manage all aspects of the day-to-day operations of claims production.

• Daily follow-up of HHC service provision in the branch with in-site team.

• Manage the complex general liability of claims.

• Supervising the implementation of best practices based on related authorities.

• Determine and delegate claims settlement authority to claims representatives.

• Identify strategic opportunities based on financial analysis and projections, cost/benefit identification and analysis.

• Discuss the complicated claims with team to help in preventing fraud.

• Ensure claim Performance quality.

Technical support

• Provide support, guidance, leadership and motivation to promote maximum performance.

• Provide technical guidance to staff on claim investigation, reserving evaluation and resolution of claims.

• Keep the team up-to-date in regulations released by related authorities.

• Apply appropriate interventions and follow up on identified projects.

Rejection

• Analysis of rejection statement (medical / technical), and put plans to avoid them.

• Explain rejection reason to claim's team.

Project supervision

• Partner with related teams to produce necessary results.

• Interact extensively with various parties involved in the claim process.

• Conduct annual plan and budget preparation under guidance provided by leadership.

• Collaborate with other branches and business leaders to define and drive enterprise initiatives.

• Create an environment that encourages and values the opinions of others and promotes sharing of information and ideas.

Stakeholders' engagement

• Claim's activity reports for senior management (weekly - monthly).

• Preparing progression report.

• Provide staff with standards of performance and inform them of job expectations.

• Maintain good relationships and communication with payers.

• Regular meeting with partners leaders and submission of reports.

مسؤول التأمين

مراجعة المطالبات

• إدارة جميع جوانب العمليات اليومية لإعداد المطالبات.

• المتابعة اليومية لتقديم خدمات الرعاية الصحية المنزلية في الفرع مع فريق العمل الميداني.

• إدارة المسؤولية العامة المعقدة للمطالبات.

• الإشراف على تطبيق أفضل الممارسات بناءً على الجهات المختصة

.
• تحديد وتفويض صلاحية تسوية المطالبات لممثلي المطالبات

.
• تحديد الفرص الاستراتيجية بناءً على التحليل والتوقعات المالية، وتحديد وتحليل التكلفة والفائد

ة.
• مناقشة المطالبات المعقدة مع الفريق للمساعدة في منع الاحتيا

ل.
• ضمان جودة أداء المطالبا

ت.
• الدعم الف

ني
• تقديم الدعم والتوجيه والقيادة والتحفيز لتحقيق أقصى قدر من الأدا

ء.
• تقديم التوجيه الفني للموظفين بشأن التحقيق في المطالبات، وتقييمها، وتسويته

ا.
• إبقاء الفريق على اطلاع دائم باللوائح الصادرة عن الجهات المختص

ة.
• تطبيق التدخلات المناسبة ومتابعة المشاريع المحدد

ة.
• الر

فض
• تحليل بيان الرفض (الطبي/الفني)، ووضع خطط لتجنب

ه.
• شرح سبب الرفض لفريق المطالبة. الإشراف على المشر

وع
• التعاون مع الفرق ذات الصلة لتحقيق النتائج المطلوب

ة.
• التفاعل بشكل مكثف مع مختلف الأطراف المعنية بعملية المطالب

ة.
• إعداد الخطة السنوية والميزانية بتوجيه من القياد

ة.
• التعاون مع الفروع الأخرى وقادة الأعمال لتحديد مبادرات المؤسسة ودفعه

ا.
• تهيئة بيئة تشجع وتُقدّر آراء الآخرين، وتشجع على تبادل المعلومات والأف

ك

ار.

إشراك أصحاب الم

صلحة
• تقارير نشاط المطالبة للإدارة العليا (أسبوعيًا - شه

ريًا).
• إعداد تقرير ا

لتقدم.
• تزويد الموظفين بمعايير الأداء وإطلاعهم على توقعات

العمل.
• الحفاظ على علاقات وتواصل جيدين مع الجهات ال

دافعة.
• عقد اجتماعات منتظمة مع قادة الشركاء وتقديم الت

قارير.

Insurance officer

Claims Reviewing:

• Manage all aspects of the day-to-day operations of claims production.

• Daily follow-up of HHC service provision in the branch with in-site team.

• Manage the complex general liability of claims.

• Supervising the implementation of best practices based on related authorities.

• Determine and delegate claims settlement authority to claims representatives.

• Identify strategic opportunities based on financial analysis and projections, cost/benefit identification and analysis.

• Discuss the complicated claims with team to help in preventing fraud.

• Ensure claim Performance quality.

Technical support:

• Provide support, guidance, leadership and motivation to promote maximum performance.

• Provide technical guidance to staff on claim investigation, reserving evaluation and resolution of claims.

• Keep the team up-to-date in regulations released by related authorities.

• Apply appropriate interventions and follow up on identified projects.

Rejection

• Analysis of rejection statement (medical / technical), and put plans to avoid them.

• Explain rejection reason to claim's team.

Project supervision

• Partner with related teams to produce necessary results.

• Interact extensively with various parties involved in the claim process.

• Conduct annual plan and budget preparation under guidance provided by leadership.

• Collaborate with other branches and business leaders to define and drive enterprise initiatives.

• Create an environment that encourages and values the opinions of others and promotes sharing of information and ideas.

• oriented in NPHEIS platform

Stakeholders' engagement

• Claim's activity reports for senior management (weekly - monthly).

• Preparing progression report.

• Provide staff with standards of performance and inform them of job expectations.

• Maintain good relationships and communication with payers.

• Regular meeting with partners leaders and submission of reports.

مسؤول التأمين

مراجعة المطالبات

• إدارة جميع جوانب العمليات اليومية لإعداد المطالبات.

• المتابعة اليومية لتقديم خدمات الرعاية الصحية المنزلية في الفرع مع فريق العمل الميداني.

• إدارة المسؤولية العامة المعقدة للمطالبات.

• الإشراف على تطبيق أفضل الممارسات بناءً على الجهات المختصة

.
• تحديد وتفويض صلاحية تسوية المطالبات لممثلي المطالبات

.
• تحديد الفرص الاستراتيجية بناءً على التحليل والتوقعات المالية، وتحديد وتحليل التكلفة والفائد

ة.
• مناقشة المطالبات المعقدة مع الفريق للمساعدة في منع الاحتيا

ل.
• ضمان جودة أداء المطالبا

ت.
• الدعم الف

ني
• تقديم الدعم والتوجيه والقيادة والتحفيز لتحقيق أقصى قدر من الأدا

ء.
• تقديم التوجيه الفني للموظفين بشأن التحقيق في المطالبات، وتقييمها، وتسويته

ا.
• إبقاء الفريق على اطلاع دائم باللوائح الصادرة عن الجهات المختص

ة.
• تطبيق التدخلات المناسبة ومتابعة المشاريع المحدد

ة.
• الر

فض
• تحليل بيان الرفض (الطبي/الفني)، ووضع خطط لتجنب

ه.
• شرح سبب الرفض لفريق المطالبة. الإشراف على المشر

وع
• التعاون مع الفرق ذات الصلة لتحقيق النتائج المطلوب

ة.
• التفاعل بشكل مكثف مع مختلف الأطراف المعنية بعملية المطالب

ة.
• إعداد الخطة السنوية والميزانية بتوجيه من القياد

ة.
• التعاون مع الفروع الأخرى وقادة الأعمال لتحديد مبادرات المؤسسة ودفعه

ا.
• تهيئة بيئة تشجع وتُقدّر آراء الآخرين، وتشجع على تبادل المعلومات والأف

كار.٠ موجه نحو منصة NP

H

EIS

إشراك أصحاب الم

صلحة
• تقارير نشاط المطالبة للإدارة العليا (أسبوعيًا - شه

ريًا).
• إعداد تقرير ا

لتقدم.
• تزويد الموظفين بمعايير الأداء وإطلاعهم على توقعات

العمل.
• الحفاظ على علاقات وتواصل جيدين مع الجهات ال

دافعة.
• عقد اجتماعات منتظمة مع قادة الشركاء وتقديم الت

قارير.

• JOB SUMMARY

The insurance doctor is responsible for managing all insurance-related activities for the hospital, ensuring that medical claims are accurate, compliant, and processed efficiently to maximize reimbursement and minimize denials. It is a hybrid role combining deep clinical knowledge, insurance expertise, data analysis, team leadership, and process improvement.

• KEY ACTIVITIES AND RESPONSIBILITIES

• Evaluate and process claims in accordance with insurance policy, terms and conditions, and MNGHA policies and procedures. Review medical reports and ensure proper entry and compatibility with the services provided by the hospital.

• Check the accuracy of medical information with supporting documents (i.e., laboratory, pharmaceutical, radiology, etc.).
• Communicate with the treating physician/medical team for any clarification or completion of missing information.
• Escalate pending cases to the concerned department and follow up directly with Medical Services. Coordinate and follow up with the approving officer(s) on discrepancies in the official form.
• Collaborate with the claims section team on clinical queries/requests to reassess the claims.
• Collaborate and communicate with insurance company representatives, such as claims adjusters or medical reviewers, to provide additional information or clarification about the medical services provided.
• Develop a billing system to improve Revenue Cycle Management (RCM) and decrease the number of rejections. Report any observations related to claims that may affect the RCM.
• Facilitate the reconciliation process, respond to rejected claims with proper justifications in accordance with the insurance requirements, and coordinate with the insurance companies for resubmission in a timely manner.
• Participate in establishing, developing, and implementing guidelines to evaluate and process medical claims.
• Assuring requires preauthorization or prior approval for specific treatments, procedures, or medications.
• Collect sufficient information for each issue and escalate it to the concerned department.
• Provide professional advice to subordinates on all aspects of medical insurance practice and law.
• Assume the responsibilities of Claims Analyst as and if required.
• Prepare and present necessary reports and correspondences as required by the Executive Management and Senior Executive Management.

• Perform other job-related duties.

• Key Result Areas

• Weekly/Monthly Claims Processed

• Coding & Documentation Accuracy
• Query Resolution Time
• Reduction in Missing Information
• Reduction in Claim Rejection/Denial Rate
• Reduction in Pending Cases
• Discrepancy Resolution
• Timely Resubmission
• Reduction in Write-offs
• Timeliness and accuracy of financial reports produced
• Number Reporting breaches identified

• Consolidations, Reporting & Analysis

• Qualifications

Degree in Medicine or equivalent

• Technical Skills
• Knowledge of CBAHI, Ministry of Health care policy and procedure.
• Knowledge of the health care sector.
• Knowledge of Medical coding, billing process and Clinical Documentation for RCM
• Clinical Understanding
• Work-stream leads, subordinates, healthcare team, physicians, insurance companies
• High paced environment with intense deadlines

• Great deal of details and accuracy

• Behavioural Skills

• Attention to Detail
• Professional Communication
• Analytical Skills: Ability to analyse denial trends and identify root causes
• Problem-Solving: Proactive in creating solutions to prevent future claim rejections
• Persistence & Follow-up: Tenacity in managing the appeals and resubmission process.
• Business Acumen
• Strategic Thinking
• Leadership Skills
• Ethical and Personal Integrity

‏⁦
About the Role:

We are seeking a detail-oriented and knowledgeable
Insurance Specialist
to join our team. In this role, you will be responsible for managing insurance claims, verifying policy coverage, and ensuring compliance with industry regulations. You will act as the liaison between clients, insurance companies, and internal departments to ensure efficient and accurate handling of insurance-related matters.

Key Responsibilities:

• Review and process insurance claims and documentation.
• Verify insurance policy coverage and ensure compliance with company policies and legal regulations.
• Communicate with clients, providers, and insurance carriers to resolve issues.
• Maintain accurate records of all insurance-related transactions.
• Provide guidance and clarification on coverage options and claim procedures.
• Identify and escalate complex or disputed claims as needed.
• Stay up to date on industry changes, trends, and best practices.

Qualifications:

• Bachelor's degree in Business Administration, Finance, Insurance, or related field.
• Strong knowledge of insurance policies, claims processing, and regulatory requirements.
• Excellent analytical, organizational, and communication skills.
• Proficient in Microsoft Office and insurance management software.

Preferred Skills:

• Industry certifications (e.g., CPCU, AINS) are a plus.
• Experience with both health and property & casualty insurance is highly desirable.
• Bilingual abilities may be preferred depending on region/client base

⁩

Job Objective:

To manage and coordinate all insurance-related processes, including health insurance, general insurance (such as property, vehicle, and liability), by working closely with insurance providers, internal teams, and clients to ensure coverage accuracy, policy compliance, and timely processing of claims.

Key Responsibilities:

• Coordinate with insurance companies to arrange, renew, or update insurance policies.
• Review insurance policy terms and ensure they align with company or client requirements.
• Handle and follow up on insurance claims, ensuring all necessary documentation is complete and submitted.
• Provide assistance to employees or clients regarding insurance coverage and inquiries.
• Prepare periodic reports on insurance status, claims, renewals, and pending issues.
• Verify and process insurance-related invoices and documentation.
• Ensure compliance with local insurance regulations and internal policies.
• Evaluate insurance offers and contribute to selecting the most suitable provider.
• Maintain accurate insurance records and documentation for audits and reviews.
• Assist in developing and improving internal insurance procedures and policies.

Required Qualifications:

• Bachelor's degree in Business Administration, Insurance, Finance, or a related field.
• 2–5 years of experience in the insurance field (health, general, or both).
• Strong knowledge of local insurance laws, policies, and market practices.
• Excellent communication and customer service skills.
• Proficiency in MS Office (Excel, Word, Outlook).
• Strong attention to detail and document analysis.

Preferred Skills:

• Previous experience with insurance brokers or insurance companies.
• Familiarity with electronic insurance systems (e.g., Najm, CCHI portals – for Saudi Arabia).
• Strong negotiation skills with insurance providers.
• Excellent time management and organizational abilities.

نوع الوظيفة: دوام كامل

الراتب المدفوع: ﷼٤٬٠٠٠٫٠٠ لكل شهر

Overview

Job Title

Insurance Access Manager

Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to:

• Career development with an international company where you can grow the career you dream of.
• Insert key local benefits that differentiate us in the market.
• A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune.
• A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists.

The Opportunity

This position works out of our Jeddah. On site. location in the Established Pharmaceuticals division.

Divisional Information

Established Pharmaceuticals

We are committed to bringing the benefits of our trusted medicines to more people in the world’s fastest-growing countries. Our broad portfolio of high-quality and differentiated branded generic medicines reaches across multiple therapeutic areas including gastroenterology, womens health, cardiometabolic, pain management/central nervous system, and respiratory.

Develop insurance companies’ strategies plan to achieve

• Proper item listing and reimbursement.
• Proper coverage criteria.
• Proper coding and approved indications.

• Create long term engagement plan with insurance companies.
• Monitor policy and regulatory insurance market changes and define business threats and opportunities.
• Agree with insurance companies on coding of Abbott products and mapping.
• Field visit and regular engagement with insurance companies KOL in medical and clinical governance and approval department.

Develop hospital insurance access plan with insurance managers, delegates, approval and claiming department to guarantee

• Full dispensing and approval cycle monitoring.
• Mitigate any rejection of Abbott products.
• Agreed on items’ coverage criteria.
• Identify any dispensing gap and coordinate with insurance companies if needed.
• Share insights for coding and indications, approval submission data for Abbott products.
• Conduct regular field visits and group meeting along with creation and presentation of insurance patient profile.

Cross functional and internal stakeholder collaboration including

• Commercial and trade team support for provider and payer insurance statues.
• Collaborate and support medical representatives to mitigate insurance risks inside hospitals.
• Collaborate with medical team for item coding and coverage criteria.
• Monitor and update new insurance regulation with internal RA, marketing, and sales team.
• Support product selection and proactive launching activities of new product.
• Induction and training of medical representatives (day to day field challenges and new dynamics).

Maximize commercial access opportunities and mitigate new market challenges by

INN prescription rules readiness and risk mitigation strategy

• Share dynamics and regulations with all internal stakeholders.
• Collaborate with all teams to monitor implementation process across hospitals.
• Analyze expected impact and risk.
• Support trade and commercial team decision with innovative listing techniques.

IDF Project implementation

• Capture insights and feedback from project regulator and executers (CCHI-IQVIA-Accumed-Nephies team).
• Monitor Abbott item positioning and agreed coverage points.
• Calculate insurance classes categorization business impact.
• Capture feedback and insights of insurance companies and implementation plan from this side.
• Participate in hospital purchasing meeting with trade KAM to assure proper enlisting process.
• Work on hospital profile project from insurance perspective and impact on private business.

Private market access activity lead

Support adapting of MCDA concept with trade and hospital purchasing department.

Define HTA, economic concept and how to use to maximize patient and product access.

Required Qualifications

Bachelor’s in pharmacy or related to medical field.

Minimum Experience Required

3-5 years of relevant experience.

Minimum Skills Required

• Technical knowledge.
• Previous experience needed.
• Main soft skills required.
• Language skills.
• IT skills (Microsoft Office, specific software, etc.).
• Requirements to sign an internship.
• Desirables and other info.

Abbott is an Equal Opportunity Employer, committed to employee diversity.

Connect with us at Abbott.com, on Facebook, and on Twitter @AbbottNews and @AbbottGlobal.

We are looking for a professional employee in the field of medical insurance to join our team. The candidate must have at least two years of experience in the field of medical insurance management. His role will be essential in ensuring the implementation of policies and procedures related to medical insurance with high efficiency.

Tasks

1. Contracting with insurance companies .

2. Negotiating with insurance companies to conclude contracts and ensuring comprehensive and satisfactory coverage for customers.

3. Claims management.

4. Coordinate and manage all aspects of medical insurance in the medical complex.

5. Follow up on insurance policy updates and apply them according to the latest standards and regulations.

6. Follow up on patient transactions and synchronize with insurance companies to ensure prompt and accurate compensation.

7. Cooperate with the billing and finance team to ensure effective collection of fees.

8. Provide advice and guidance to patients on insurance details and costs.

Required experience:

At least 2-3 years of experience in the field of medical insurance

Requirements:

1. A degree in health services management or a related field.

2 At least two years of experience in medical insurance management.

.3 Excellent communication skills and ability to deal with the public and insurance companies.

1. Strong knowledge of health insurance regulations and policies in the Kingdom of Saudi Arabia.

.5 Teamwork skills .

6 Familiarity with technology and electronic systems used in the field of medical insurance.

Job Types: Full-time, Contract

Pay: ﷼4, ﷼6,000.00 per month