Medical Insurance Officer

About The Role

Key Responsibilities

• 1.
• Handling Medical Insurance RFQs & Policy Issuance
• Process requests for quotations (RFQs) and obtain competitive quotes from insurers.
• Compare policy options and prepare professional proposals based on client needs.
• Issue policies, endorsements, and renewals, ensuring accuracy and compliance.
• Maintain organized records of medical policies and follow up on renewals and payments.

2. Managing Medical Insurance Service Requests

• Handle customer inquiries regarding coverage details, mid-term adjustments, and policy modifications.
• Process policy changes efficiently and ensure accurate documentation.
• Coordinate with insurance providers and TPAs for approvals and updates.
• Assist in premium calculations and ensure timely policy renewals.

3. Medical Insurance Claims Administration

• Guide clients through the claims process, ensuring required documents are submitted.
• Liaise with insurers, TPAs, and healthcare providers for claim approvals and settlements.
• Follow up on claim statuses and provide clients with regular updates.
• Ensure fair claim settlements and assist in resolving disputes when necessary.
• Maintain detailed records of claims and analyze trends to improve policy recommendations.

Key Skills & Competencies

• Strong knowledge of medical insurance policies and claims procedures.
• Experience dealing with healthcare providers, TPAs, and insurance carriers.
• Excellent administrative and organizational skills.
• Strong communication and customer service abilities.
• High attention to detail and ability to analyze medical insurance documentation.
• Proficiency in insurance management software and Microsoft Office Suite.
• Ability to work under pressure and meet deadlines.

Qualifications & Experience

• **Education:**
• Bachelor's degree in Business Administration, Pharmacy, Healthcare Management, or a related field is preferred.
• **Experience:**
• 3-5 years in medical insurance (brokerage, insurance company, TPA, or healthcare provider).
• **Language:**
• Proficiency in Arabic & English preferred.