Specialist Medical Insurance Administration III📣 Job Ad

About Ma’aden and the Role

Ma’aden is seeking a Specialist, Medical Insurance Administration III to join its team in Riyadh. This full-time role is central to managing and administering employee medical insurance services, overseeing work injury processes, and coordinating healthcare activities. The Specialist ensures all operations comply with relevant regulatory requirements and company policies, contributing to the overall well-being of employees.

Role Purpose

The primary purpose of this position is to support employees' medical needs through effective medical insurance administration, meticulous claims management, and proactive coordination with healthcare providers. The role also ensures strict adherence to occupational health compliance standards, providing essential support for the workforce.

Key Responsibilities

• Administer employee medical insurance programs in full compliance with Health Insurance Council (CHI) regulations.
• Coordinate insurance approvals, manage coverage inquiries, handle escalations, and monitor medical coverage limits.
• Review, validate, and process employee medical expense claims according to company policies.
• Manage GOSI registration, reporting, and follow-up procedures for all work-related injury cases.
• Coordinate pre-employment medical examinations for new hires.
• Maintain accurate medical insurance and employee healthcare records.
• Provide support to employees regarding medical insurance inquiries and healthcare service requirements.
• Ensure the quality and effectiveness of healthcare providers, including company clinics and external medical facilities.
• Conduct site visits to hospitals and medical facilities to monitor service quality and compliance with approved healthcare standards.
• Coordinate medical travel arrangements for employees requiring specialized treatment both within and outside the Kingdom.

Qualifications and Experience

• Bachelor’s degree in Healthcare Administration, Business Administration, Human Resources, or a related field.
• Minimum of 2 years of experience, with a preferred range of 2-5 years, in medical insurance administration, healthcare services, employee medical support, or a related healthcare field.

Work Environment and Location

This is a full-time position based in Riyadh, Saudi Arabia. The role involves working within a dynamic environment that requires close coordination with various internal departments and external healthcare providers to ensure seamless medical support for employees.

Application Information

Candidates who meet the specified qualifications are encouraged to apply. Ma’aden is committed to attracting and retaining skilled professionals to contribute to its operations.