Description

Job Description

Company Description

Premium Care Medical Center is a growing healthcare provider based in Tabuk, Saudi Arabia, offering comprehensive outpatient services with a strong focus on quality, efficiency, and patient experience.

The center is equipped with advanced diagnostic facilities and serves both individual and corporate clients. As part of our ongoing expansion and insurance network growth, we are strengthening our Revenue Cycle Management (RCM) operations to ensure optimal claim performance and compliance

Role Description

This is a full-time, on-site role for a Medical Insurance Officer responsible for managing end-to-end insurance operations, including pre-authorizations, claims processing, system alignment, and payer communication.

The role requires hands-on experience in medical coding, billing accuracy, Waseel integration, and claim rejection control, with a strong ability to coordinate between clinical and administrative teams.

Key Responsibilities

• Manage and process pre-authorization requests efficiently to ensure timely approvals
• Perform accurate medical coding and billing, minimizing rejection rates
• Ensure proper internal mapping and system alignment with Waseel to avoid technical claim issues
• Handle claim submissions, tracking, and reconciliation with insurance companies
• Analyze rejected claims and implement corrective actions to improve approval rates
• Coordinate with physicians to ensure appropriate service selection, documentation, and ordering practicesaligned with insurance requirements
• Act as the main point of contact with insurance providers for approvals, claims, and dispute resolution
• Support onboarding and negotiation with new insurance companies and contracts
• Ensure full compliance with Council of Cooperative Health Insurance (CHI/CCHI) regulations
• Continuously improve internal workflows to optimize revenue cycle performance