Job Description

Job Brief:

Are you a medically qualified professional experienced in handling medical approvals and insurance coordination? Do you have a strong understanding of clinical evaluation and policy compliance?
If so,

you are the one we are looking for!

This is an excellent opportunity to join a reputed medical insurance management team, where you will evaluate treatment requests, ensure compliance with medical guidelines, and maintain accuracy in medical authorization processes while working closely with healthcare providers.

Note: To be considered, you must be willing to relocate to Saudi Arabia.

Key Responsibilities:

Evaluate

prior authorization requests

for medical necessity based on provided medical reports and documentation.

Code medical services

accurately and classify cases (inpatient, outpatient, emergency, etc.) as per standard clinical practices. Verify that all requested services comply with

best medical practices

and

insurance policy terms

. Identify, document, and

report misuse or potential fraud cases

, ensuring necessary preventive actions are implemented.

Monitor utilization patterns

, detect early warning signs, and recommend cost-control measures. Respond promptly to inquiries from hospitals, clinics, and pharmacies to ensure smooth

case coordination

. Handle

second opinion and case management requests

and escalate complex cases to senior medical officers. Participate in

night shifts and holiday rosters

as assigned.

Prepare daily and monthly activity reports

as required by management. Validate the

accuracy of services and pricing

, identifying areas for cost optimization. Communicate with clients and providers in a professional and timely manner in accordance with company guidelines. Perform any other duties assigned by the direct supervisor related to the role.

Required Qualification / Experience / Skills:

Bachelor's or Master's Degree in General Medicine & Surgery*.

Min 1

year of Saudi experience in medical approvals, insurance claims, or healthcare administration Familiarity with medical coding systems (ICD, CPT, etc.) Strong understanding of clinical practices and medical policy interpretation Proficiency in Microsoft Office and healthcare management systems Excellent communication and coordination abilities Strong analytical and decision-making skills Ability to handle multiple cases efficiently under pressure

Job Location: Saudi Arabia

Type of Employment: Permanent / Full-time

Salary Range: 7,000 - 12,000 SAR based on experience

What you can expect from the employer:

Competitive salary package based on experience

Dynamic and growth-oriented work environment

Training and career advancement opportunities

All other benefits as per Saudi Employment Law

Job Types: Full-time, Permanent

Pay: ₹49,643.95 - ₹281,346.55 per month

Benefits:

Health insurance Paid sick time Paid time off
Application Question(s):

Do you hold a Bachelor's or Master's degree in General Medicine & Surgery? How many years of experience do you have in medical approvals or insurance management? Are you familiar with medical coding systems (ICD, CPT, etc.)? Do you have prior experience in coordinating with hospitals, clinics, or insurance providers? Are you willing to relocate Saudi
Work Location: In person