Insurance Pharmacist
Posted today
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Overview
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 Description- Work as a back line support with pharmacists to help them if they have any insurance quires.
- Follow up the rejected pre authorization requests and process on it to get approval if the request is covered by CHI policy and medically justified.
- Communicate directly with insurance companies’ doctors and delegates to gain approval for medications.
- Managing and handling the missed pre authorization requests.
- Keep updated with the new insurance companies policies and medical guidelines to apply the exceptions or additional rules in each. This will help to take fast decision and proceed the approval.
- Work with patients to help them understand their insurance coverage and answer any related queries they might have.
- Update the list of not covered medications according to CHI new rules and insurance companies’ different policies.
- Update the drug formulary classification according to updated IDF of SFDA drug list to correctly implement the new deductible policy of CHI.
- Train front line pharmacists and keep them updated about insurance details.
- Make data analysis for the rejected medications to avoid the rejection reasons in the future claims.
- Perform other professional duties requested from line manager.
- Education Degree :Bachelor degree in pharmaceutical since.
- Years of Experience :minimum of two years’ experience in the same field
- Certificate: Insurance foundation certificate.
HR Specialist (Medical Insurance)
Posted 17 days ago
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Job Description
We are USC – Join us and make your career future ready!
Think bigger scale. Think higher profile. Think ground-breaking. Join USC, and you’ll be at the heart of a team of international experts all dedicated to growing and sharing their expertise and working on projects that transform society for all of us. Investing in the human element, enhancing its belonging and releasing its energies is one of the priorities of our company, and we seek to achieve this by following various strategies, including continuous training, applying the latest technologies and management theories, and talking courageous initiatives, USC looks to the future with an optimistic view compared to its present, and in order to advance its aspirations, it works to prepare a professional staff and is keen to develop it professionally , knowledgeably and administratively.
Line manager:Head of employee Relations.
Job Objective:Supervising the management of medical insurance operations, providing the best medical services to employees, and contributing to achieving the company’s goals.
functional task and duties:Your new role, what’s involved?
- Follow-up and attention to the direct relationship with the medical insurance company or the intermediary (Broker).
- Adding Saudi employees to the company and excluding them in the event of resignation from the insurance company.
- Follow-up the financial claims submitted by the workers to the insurance company.
- Follow-up of bills addition and deletion with the insurance company.
- Follow-up promotions for the company’s employees and their cost after fulfilling the promotion requirements.
- Preparing periodic and annual reports for the services provided by the medical insurance company.
- Communicate with medical insurance companies before the end of the contract to get the offers through the intermediary (Broker) or Search in person for better medical insurance offers.
- Coordinating with the communications officer to conduct a questionnaire for the company’s employees to seek their views on the services provided by the insurance company.
- Follow-up the notes and complaints of the company’s employees regarding the service provided by the insurance company.
- Coordinating with the employment official regarding new appointments to issue the medical insurance cards for them according to the internal regulations and for non-Saudis follow-up on the transfer of their sponsorship to exclude them from the insurance.
- Coordinating with the internal auditor to reviews the insurance invoices and submitting them to the financial department for disbursement.
- Coordinating with the medical insurance company in preparing features, benefits and networks for the insurance grade.
- Carrying out the work assigned to him by the direct manager and related to the nature of his work.
- Internal relations.
- Functional relations with the director of Human Resources Department.
- Coordinating relations with the rest of the directors of the various departments of the company.
- External relations with the broker and insurance company.
- Supervision ability.
- Communication and reporting ability.
- Ability to make decisions and assume responsibilities.
- Knowledge of policies and procedure.
- University degree or experience in Human Resources Management, Administrative Affairs, it is preferable to obtain a specialized certificate in Human Resources.
Customer Service Representative
Posted 20 days ago
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Job Description
The Customer Service Representative in the Real Estate industry plays a crucial role in ensuring that clients and potential buyers receive top-notch service. This position is integral to a recruitment agency specializing in Human Resources Outsourcing for real estate firms. The representative will be responsible for addressing inquiries, providing information about properties, and assisting clients throughout the buying or renting process. A successful candidate will possess strong communication skills and a solid understanding of customer service principles tailored to the real estate market.
Responsibilities:
- Respond to customer inquiries regarding real estate listings and services through phone, email, and chat.
- Provide detailed information about properties, including pricing, features, and availability.
- Assist clients in understanding the real estate market and guide them in their property search.
- Maintain accurate records of customer interactions and property details.
- Resolve customer complaints and issues related to property transactions effectively.
- Collaborate with real estate agents and consultants to ensure a seamless customer experience.
- Conduct follow-ups with clients to ensure satisfaction and address any concerns.
- Identify opportunities for enhancing customer service processes in the real estate sector.
- Stay updated on market trends and property listings to provide informed assistance.
- Participate in training sessions to enhance knowledge of real estate services and customer service skills.
Preferred Candidate:
- Strong verbal and written communication skills specific to real estate terminology.
- Ability to work efficiently in a fast-paced environment.
- Excellent problem-solving skills and attention to detail.
- Proficient in using real estate software and customer relationship management tools.
- Ability to work collaboratively with real estate professionals and clients.
- Empathetic and patient when addressing customer concerns.
- Adaptability to changing market conditions and customer needs.
- Previous experience in the real estate or customer service industry is a plus.
- Fluency in both English and Arabic is highly desirable.
- Strong organizational skills to manage multiple inquiries effectively.
Skills
- Excellent communication skills, both verbal and written, with a focus on real estate terminology.
- Proficiency in real estate software and customer service platforms.
- Strong organizational and multitasking abilities.
- Effective problem-solving and conflict resolution skills.
- Ability to work under pressure and meet tight deadlines.
- Knowledge of real estate market trends and practices.
- Fluency in English and Arabic is a significant advantage.
- Empathy and active listening skills to cater to customer needs.
Private Health Insurance Market Access
Posted 24 days ago
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Job Description
Role Overview: Private Health Insurance Market Access will lead and manage the inclusion of EVA products, specifically those registered as health products and food supplements, within the reimbursement lists of private health insurance providers and the CHI (Council of Health Insurance). The role involves building strategic partnerships with private insurance companies, enhancing product access, and supporting sales efforts in key accounts.
Join EVA Pharma, a leading pharmaceutical company dedicated to empowering the fight for Health and well-being as a fundamental human right.
Key Responsibilities- Develop and implement access strategies for product inclusion in private health insurance.
- Prepare and submit pricing files, dossiers, and value propositions to insurance payers.
- Track and update product status across insurance companies.
- Build and manage relationships with key stakeholders in private insurers and key accounts.
- Collaborate with internal teams (Sales, Marketing, Medical, Regulatory) to support access goals.
- Monitor the insurance landscape, identify access barriers, and propose actionable solutions
- Bachelor's degree in pharmacy, Medicine, or a related field
- Minimum 3-5 years of experience in the same role in pharma companies in Saudi Arabia (e.g., Market Access, Key Account Management, Sales Management, etc)
- Strong understanding of the private insurance landscape in the region, with previous successful product inclusions within the private health insurance providers
- Strong network and relationships with private health insurance providers, key accounts, and CHI stakeholders.
- Solid business acumen with awareness of regulatory and pricing frameworks (preferred).
- Mid-Senior level
- Full-time
- Other
- IT Services and IT Consulting
HR Specialist (Medical Insurance)
Posted today
Job Viewed
Job Description
We are USC – Join us and make your career future ready!
Think bigger scale. Think higher profile. Think ground-breaking. Join USC, and you’ll be at the heart of a team of international experts all dedicated to growing and sharing their expertise and working on projects that transform society for all of us. Investing in the human element, enhancing its belonging and releasing its energies is one of the priorities of our company, and we seek to achieve this by following various strategies, including continuous training, applying the latest technologies and management theories, and talking courageous initiatives, USC looks to the future with an optimistic view compared to its present, and in order to advance its aspirations, it works to prepare a professional staff and is keen to develop it professionally , knowledgeably and administratively.
Line manager:Head of employee Relations.
Job Objective:Supervising the management of medical insurance operations, providing the best medical services to employees, and contributing to achieving the company’s goals.
functional task and duties:Your new role, what’s involved?
- Follow-up and attention to the direct relationship with the medical insurance company or the intermediary (Broker).
- Adding Saudi employees to the company and excluding them in the event of resignation from the insurance company.
- Follow-up the financial claims submitted by the workers to the insurance company.
- Follow-up of bills addition and deletion with the insurance company.
- Follow-up promotions for the company’s employees and their cost after fulfilling the promotion requirements.
- Preparing periodic and annual reports for the services provided by the medical insurance company.
- Communicate with medical insurance companies before the end of the contract to get the offers through the intermediary (Broker) or Search in person for better medical insurance offers.
- Coordinating with the communications officer to conduct a questionnaire for the company’s employees to seek their views on the services provided by the insurance company.
- Follow-up the notes and complaints of the company’s employees regarding the service provided by the insurance company.
- Coordinating with the employment official regarding new appointments to issue the medical insurance cards for them according to the internal regulations and for non-Saudis follow-up on the transfer of their sponsorship to exclude them from the insurance.
- Coordinating with the internal auditor to reviews the insurance invoices and submitting them to the financial department for disbursement.
- Coordinating with the medical insurance company in preparing features, benefits and networks for the insurance grade.
- Carrying out the work assigned to him by the direct manager and related to the nature of his work.
- Internal relations.
- Functional relations with the director of Human Resources Department.
- Coordinating relations with the rest of the directors of the various departments of the company.
- External relations with the broker and insurance company.
- Supervision ability.
- Communication and reporting ability.
- Ability to make decisions and assume responsibilities.
- Knowledge of policies and procedure.
- University degree or experience in Human Resources Management, Administrative Affairs, it is preferable to obtain a specialized certificate in Human Resources.
Insurance Coordinator
Posted today
Job Viewed
Job Description
Reviews Rechecks patient's policy number and membership number from the saved eligibility and from the System.
Records all reception related reports.
Prepare pr secure the excel sheet for the insurance audit team daily review.
Secures prior authorization (pre approval) request. Average approvals per day is from 50-80.
Assists reception staff in any insurance matter, such as coverage of the policy benefit.
Assists attending physician for any concerns regarding pre-approvals.
Responding and assists other concerned departments in checking of eligibility and or complaints from patients.
Assists the medical insurance claims section for monthly submission of claims.
Performs additinoal duties as Insurance Manager's decree.
**Salary**: ﷼4,000.00 - ﷼5,000.00 per month
Ability to commute/relocate:
- Jeddah: Reliably commute or planning to relocate before starting work (required)
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