Medical Insurance Specialist Zain

The Medical Insurance Specialist is responsible for managing and coordinating all medical insurance activities for Group and the operating countries (OpCos). The Medical Insurance Specialist is to provide guidance and support to insurance teams to ensure unified plans and policies.

Key Accountabilities

• Manage, coordinate and control all medical insurance activities over all Zain OpCos and provide guidance and support to the regional insurance officers for the proper functioning according to the unified plan & insurance policy.
• Manage and control the medical plan in respect of resolving problems through proper channel communication and coordination.
• Manage, coordinate and control premium payments, proper billing and proper contract documentation.
• Monitor & control claim reimbursement process and organize with the stakeholders for timely payment.
• Generate medical insurance statistic reports as perthe set up plan/s.
• Make certain that proper controls are in place by meeting objectives and that service standards per company guidelines are met.
• Update the health network to ensure the respective service flow & reduce medical invoices issued outside the prevailing health network.
• Follow-up activities and achievements of opcos subordinates.
• Responsible for providing support in handling complaints and inquiries for employees.
• In charge of reimbursement claim process and implementation by being the focal person between tpa, insurer & employees and insure claim settlement on timely manner.
• Create & update data base, claims & operational risks by adopting the required programs.
• Oversee & manage all administrative activities relating to medical insurance in coordination with the insurance officers in all Zain OpCo's.
• Liaise effectively with opcos coordinates to insure adequate policy implementation.
• Control and follow up the implementation of the pre set ins. Working procedures with all concerned depts. & parties within zain opcos.
• Assuring employees satisfaction in respect of health insurance services as per zain s prevailing respective policy.
• Finalize the monthly, quarterly and/or annually basis insurance reconciliations in coordination with the concerned parties.
• Prepare monthly and periodic operating reports effectively to address main goals & objectives.
• Coordinate with the OpCo's designated employees to manage the medical insurance plans.
• Maintain a harmonic work atmosphere with Zain employees to follow up on business related matters.
• Provide guidance to the designated employees to develop and enhance their insurance knowledge skills.