Specialist, Medical Insurance Administration

Maaden; Riyadh; On-site; SAR 120,000 - 180,000; Full time

Job summary

Maaden in Saudi Arabia is seeking an experienced Medical Insurance Administrator to manage employee medical insurance services, work injury processes, and healthcare coordination while ensuring regulatory and policy compliance. The role supports employees’ medical needs through effective insurance administration, claims processing, healthcare provider coordination, and occupational health compliance.

The position requires coordinating pre-employment medicals, maintaining accurate records, and

Qualifications

• Bachelor’s degree in healthcare administration, business, HR, or related field.
• Minimum 2 years in medical insurance administration or healthcare support.
• Experience with CHI regulations and GOSI preferred.

Responsibilities

• Administer medical insurance programs in compliance with CHI regulations.
• Coordinate approvals, coverage inquiries, escalations, and monitor limits.
• Review and process medical expense claims per policies.
• Manage GOSI registration and follow‑up for work-related injuries.
• Coordinate pre-employment medical examinations for new hires.
• Maintain accurate medical insurance and healthcare records.
• Support employees with insurance inquiries and healthcare needs.
• Ensure quality of healthcare providers and facilities.
• Conduct site visits to hospitals and facilities for service monitoring.
• Arrange medical travel for specialized treatment inside/outside the Kingdom.

Skills

CHI Regulations

GOSI Platform

Patient Service

Medical Terminology

Insurance Coordination

Provider Management

Hospital Experience

MS Office Suite

Communication Skills

Analytical Thinking

Time Management

English Proficiency

Education

Bachelor's degree in related field

Tools

MS Office Suite

Job description

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.

Job Purpose

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