Senior Associate Provider Support📣 Job Ad

About the Role

Bupa Arabia is seeking a Senior Associate - Provider Contract Support to join their team in Jeddah. This full-time role focuses on contract administration, pricing, coding, data extraction, and network system maintenance. The primary objective is to implement agreed department action plans and rules to achieve system efficiencies within specified timescales.

Contract Administration Responsibilities

The Senior Associate will manage various aspects of provider contracts, ensuring compliance and accuracy:

• Implement contract uniformity, standards, and regulatory compliance across all providers.
• Coordinate the logistics for contracting new providers, introducing new service codes, and renewing existing contracts.
• Ensure all provider files and system data are complete and updated consistently with agreements and amendments.
• Update systems and monitor contract expiration dates within agreed timescales.
• Review provider coding to identify and remove redundant or duplicate codes.
• Regularly monitor the expiration of providers' regulatory licensing to facilitate timely renewals.

Pricing, Benchmarking, and Coding

This role involves critical functions related to pricing, discounts, and coding to maintain system integrity and competitive positioning:

• Extract necessary data for service benchmarking and maintain updated master sheets for benchmarks.
• Conduct price comparisons against benchmarks as required.
• Identify redundant and duplicate codes to support the revamp of the coding system.
• Collect regular statements' data regarding invalid service codes and billing above agreed prices for resolution.
• Coordinate internally and externally to resolve coding and pricing defaults.
• Upload new prices, contracts, and amendments into the operating systems.
• Review the first three statements from providers with new price amendments to ensure compliance.
• Report system and statement errors to the line manager on a regular basis.

Network Management and Coordination

The Senior Associate will also contribute to network design, management, and inter-departmental coordination:

• Ensure network changes are accurately updated in the systems.
• Monitor providers, physicians, and the service finder for website support and development.
• Maintain an updated master sheet for provider network distribution.
• Extract referral data and reports to monitor the implementation of referral rules.
• Coordinate with the operating team and technical stakeholders to ensure the implementation of contract/provider additions, deletions, amendments, and significant contract milestones.

Required Experience

Candidates for this position should possess 0-1 years of relevant experience.

Location and Work Type

This is a full-time position based in Jeddah.