Specialist, Medical Insurance Administration III

Ma'aden Aluminium Company (MAC); Riyadh; On-site; SAR 89,000 - 134,000; Full time

Job summary

Ma'aden Aluminium Company (MAC) is seeking a professional to manage and administer employee medical insurance services, work injury processes and healthcare coordination, ensuring regulatory and policy compliance. You will handle CHI regulations, GOSI reporting, claims processing, pre-employment medicals, records management and provider coordination across company clinics and external facilities.

The role requires 2+ years in medical insurance administration, a Bachelor's in a related field, and

Qualifications

• Bachelor's degree in healthcare administration, Business Administration, Human Resources, or a related field.
• Minimum 2 years of experience in medical insurance administration, healthcare services, employee medical support, or a related healthcare field.

Responsibilities

• Administer employee medical insurance programs in compliance with Health Insurance Council (CHI) regulations.
• Coordinate insurance approvals, coverage inquiries, escalations and monitoring of medical coverage limits.
• Review, validate and process employee medical expense claims in accordance with company policies.
• Manage GOSI registration, reporting and follow-up for all work-related injury cases.
• Coordinate pre-employment medical examinations for new hires.
• Maintain accurate medical insurance and employee healthcare records.
• Support employees with medical insurance inquiries and healthcare service requirements.
• Ensure quality and effectiveness of healthcare providers including company clinics and external medical facilities.
• Conduct site visits to hospitals and medical facilities to monitor service quality and compliance with approved healthcare standards.
• Coordinate medical travel arrangements for employees requiring specialized treatment within and outside the Kingdom.

Skills

CHI Regulations

GOSI Platform

Patient Service

Medical Terminology

Insurance Coordination

Healthcare Provider

Microsoft Office

Communication Skills

Analytical Thinking

Time Management

English Proficiency

Education

Bachelor's degree in healthcare administration

Job description

Manage and administer employee medical insurance services work injury processes and healthcare coordination activities while ensuring compliance with regulatory requirements and company policies The role supports employees medical needs through effective insurance administration claims management healthcare provider coordination and occupational health compliance

Key Accountabilities

• Administer employee medical insurance programs in compliance with Health Insurance Council CHI regulations
• Coordinate insurance approvals coverage inquiries escalations and monitoring of medical coverage limits
• Review validate and process employee medical expense claims in accordance with company policies
• Manage GOSI registration reporting and follow-up for all work-related injury cases
• Coordinate pre-employment medical examinations for new hires
• Maintain accurate medical insurance and employee healthcare records
• Support employees with medical insurance inquiries and healthcare service requirements
• Ensure quality and effectiveness of healthcare providers including company clinics and external medical facilities
• Conduct site visits to hospitals and medical facilities to monitor service quality and compliance with approved healthcare standards
• Coordinate medical travel arrangements for employees requiring specialized treatment within and outside the Kingdom

Minimum Qualifications

Bachelor s degree in healthcare administration, Business Administration, Human Resources, or a related field.

Minimum Experience

Minimum 2 years of experience in medical insurance administration, healthcare services, employee medical support, or a related healthcare field.

Skills

• Knowledge of Health Insurance Council (CHI) Regulations
• GOSI Platform Management
• Patient Service Experience and Employee Medical Support
• Knowledge of Medical Terminology
• Medical Insurance Coordination and Provider Management
• Hospital and Healthcare Industry Experience
• Microsoft Office (Excel, Word, PowerPoint, Outlook)
• Strong Communication and Stakeholder Management Skills
• Analytical Thinking and Problem Solving
• Time Management, Planning, and Organization
• English Language Proficiency

Competencies

• Teamwork
• Integrity
• Care
• Ownership
• Communication
• Accountability
• Customer Focus
• Analytical Thinking
• Problem Solving
• Planning and Organizing
• Service Excellence