Job Description

Description

About the Role
We are seeking a skilled and dedicated Claim Specialist to lead our Revenue Cycle Management team, ensuring high-quality claims submission and timely fund collection from insurance companies and corporate partners.

Key Responsibilities

• Provide strong leadership and daily task distribution to the RCM Officers team.
• Ensure invoices and claims are accurate, complete, and compliant with CHI regulations before submission to insurers and private payers.
• Verify that approvals, discounts, coding, and eligibility checks are correctly applied to all bills.
• Oversee preparation and analysis of dispatch, collection, and submission reports, ensuring the system reflects accurate payment and outstanding balance data.
• Generate and review age analysis reports and ensure timely statements/reminders are sent to clients.
• Drive achievement of individual and team collection targets in line with hospital policies.
• Ensure rejected/disallowed claims are correctly allocated and resubmitted within stipulated timeframes.
• Prepare final reconciliation statements in collaboration with the Claim/RCM Lead.
• Support employee development through coaching, training, and performance reviews.

Requirements

Qualifications

• Bachelor’s Degree or Diploma from an accredited institution.
• Minimum 3 years’ experience in billing/accounts within the healthcare industry.
• Prior experience in a team lead role in claim management within KSA.
• Licensed professional coder is a plus.

Skills & Competencies

• Strong knowledge of local insurance companies, TPAs, and CHI regulations.
• Excellent leadership, analytical, and decision-making skills.
• Strong communication skills in English (Arabic is a plus).
• Ability to manage a team in a fast-paced, multicultural healthcare environment.
• Patient and stakeholder-centered approach with a commitment to quality and humanization in service delivery.