Medical inurance

About Safa Bawadi Polyclinic

Safa Bawadi Polyclinic is a leading multidisciplinary healthcare facility dedicated to delivering high-quality, patient-centered medical services across the Riyadh Region. Committed to operational excellence and clinical integrity, the clinic offers a comprehensive range of healthcare solutions, including primary care, specialty consultations, diagnostic services, and coordinated medical insurance support. Our mission is to ensure accessible, efficient, and transparent healthcare delivery through streamlined processes, continuous improvement, and a supportive work environment. We uphold the highest standards of professionalism, respect, and collaboration, fostering a culture where every team member contributes to the well-being of our patients and the success of our organization.

Position Overview

We are seeking a detail-oriented and proactive Medical Insurance Specialist to join our dynamic team at Safa Bawadi Polyclinic. This full-time, hybrid role is based in the Riyadh Region and offers a blend of on-site responsibilities at our clinic and flexible work-from-home opportunities. The ideal candidate will play a pivotal role in ensuring seamless insurance coordination, accurate claim processing, and compliance with regulatory standards. By acting as a liaison between patients, insurance providers, and internal clinical teams, you will facilitate smooth financial transactions, reduce claim denials, and enhance the overall patient experience. This position is ideal for a motivated professional with a strong background in healthcare administration, insurance coordination, or related fields, who is eager to contribute to operational efficiency and revenue cycle management.

Key Responsibilities

• Insurance Verification & Eligibility: Conduct thorough verification of patients’ insurance coverage and eligibility, ensuring all details are accurately documented in clinic systems. Communicate with insurance providers to clarify benefits, limitations, and patient responsibilities.
• Pre-Authorization & Approval Coordination: Facilitate the pre-authorization process for medical procedures, treatments, and diagnostic tests by liaising with insurance companies, healthcare providers, and patients to obtain necessary approvals in a timely manner.
• Claims Submission & Management: Prepare, submit, and track insurance claims in accordance with clinic protocols and regulatory requirements. Monitor claim statuses, follow up on pending or rejected claims, and resolve discrepancies to ensure timely reimbursement.
• Billing Support & Reconciliation: Assist in billing processes by verifying claim accuracy, reconciling payments, and identifying discrepancies. Collaborate with the finance team to resolve billing issues and minimize revenue cycle delays.
• Compliance & Documentation: Ensure adherence to insurance policies, healthcare regulations, and clinic standards. Maintain up-to-date records of insurance plans, claim submissions, and patient communications while safeguarding confidential information.
• Process Improvement: Identify opportunities to streamline insurance-related workflows, reduce errors, and enhance operational efficiency. Contribute innovative ideas to improve patient satisfaction and financial performance.
• Cross-Functional Collaboration: Work closely with clinical staff, administrative teams, and insurance representatives to resolve issues, clarify coverage details, and provide exceptional service to patients.

Qualifications & Skills

To excel in this role, candidates must possess a combination of technical expertise, interpersonal skills, and industry knowledge. The following qualifications and attributes are essential:

• Professional Experience: Proven experience in medical insurance coordination, including eligibility verification, pre-authorization, and claims submission within a healthcare, clinic, hospital, or insurance company setting.
• Technical Knowledge: Solid understanding of healthcare billing processes, medical terminology, and basic coding principles (e.g., ICD-10, CPT codes). Familiarity with healthcare management software and electronic health records (EHR) systems is highly desirable.
• Analytical & Organizational Skills: Exceptional attention to detail for accurate data entry, documentation, and record-keeping. Ability to manage multiple tasks, prioritize workloads, and meet deadlines in a fast-paced environment.
• Communication & Interpersonal Abilities: Strong verbal and written communication skills to interact professionally with patients, insurance representatives, and internal teams. Fluency in English is mandatory; proficiency in Arabic is a significant advantage.
• Problem-Solving & Adaptability: Demonstrated ability to troubleshoot complex claims, resolve discrepancies, and adapt to evolving insurance policies and regulations. A proactive approach to continuous learning and process improvement.
• Educational Background: A relevant diploma or degree in healthcare administration, business administration, finance, or a related field is preferred. Certifications in medical billing, coding, or insurance coordination are a plus.

Work Environment & Benefits

Safa Bawadi Polyclinic offers a supportive and collaborative work environment where professional growth and work-life balance are prioritized. As a hybrid role, this position provides the flexibility to work both on-site at our modern clinic facility and remotely, ensuring a dynamic and adaptable work experience. We are committed to investing in our team members through continuous training, career development opportunities, and a comprehensive benefits package that includes competitive compensation, health insurance, and other employee perks.

If you are a detail-oriented professional with a passion for healthcare administration and insurance coordination, we invite you to apply and become an integral part of our mission to deliver exceptional patient care and operational excellence.