Claims Specialist

Department: Revenue Cycle Management

About the Role

We are seeking a skilled Claim Specialist to oversee claims submission and fund collection from insurance companies and corporate partners while leading a high-performing RCM team.

Responsibilities

• Lead the RCM Officers team and manage daily task distribution.
• Ensure accurate, complete, and CHI-compliant invoices and claims prior to submission.
• Oversee dispatch, collection, and submission reports and maintain accurate payment records.
• Manage rejected/disallowed claims and ensure timely resubmission.
• Drive individual and team collection targets in line with hospital policies.

Qualifications

• Bachelor's degree in medicine or healthcare.
• Minimum 3 years' experience in billing/accounts within the healthcare industry.
• Prior experience in a claim management team lead role within KSA.
• Licensed professional coder is a plus.
• Strong knowledge of local insurers, TPAs & CHI regulations.