SENIOR MEDICAL CLAIMS ANALYST.

Johns Hopkins Aramco Healthcare

Employer Active

Posted 9 hrs ago

Experience

4 - 9 Years

Job Location

Eastern Province - Saudi Arabia

Education

Any Graduation

Nationality

Any Nationality

Gender

Not Mentioned

Vacancy

1 Vacancy

Job Description

Roles & Responsibilities

Job Description Summary

Quality-focused role owning team-level accuracy and complex case resolution. Responsible for leading quality initiatives, resolving escalated disputes, and mentoring junior staff while contributing to policy refinement.

Strategic Roles & Responsibilities

  • Lead quality audit initiatives and implement corrective actions
  • Contribute to policy refinement based on claim pattern analysis
  • Mentor and develop junior staff capabilities

Operational Roles & Responsibilities

  • Lead quality audits for the claims team, analyzing root causes of errors
  • Implement corrective actions to reduce claim processing errors
  • Resolve escalated provider disputes involving moderate-complexity clinical determinations
  • Develop claim review checklists for high-frequency scenarios using trend data
  • Update and refine policies based on claim pattern analysis
  • Mentor junior staff on policy interpretation and dispute resolution
  • Conduct training sessions on complex claim scenarios
  • Maintain expertise in regulatory changes and industry best practices

Functional Competencies

  • Accounts Receivable
  • Billing Investigations
  • Billing Statement Preparation

Core Competencies

  • Excellence
  • Integrity
  • Accountability
  • Cybersecurity
  • Person-Centered Care

Desired Candidate Profile

Minimum Education Required

Bachelor degree in healthcare administration, business, or related field

Professional Certifications Required

Professional certification (e.g., CPC, CPB) preferred

Years of Experience

4-6 years of progressive claims processing experience in healthcare or insurance

Languages

  • Arabic : Advanced
  • English : Advanced

Company Industry

  • Medical
  • Healthcare
  • Diagnostics
  • Medical Devices

Department / Functional Area

  • IT Software

Keywords

  • SENIOR MEDICAL CLAIMS ANALYST.

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Johns Hopkins Aramco Healthcare

https://careers.jhah.com/job/Dhahran-SENIOR-MEDICAL-CLAIMS-ANALYST_/856898023/