WTW (Willis Towers Watson) is a global advisory, broking, and solutions company that helps clients around the world turn risk into a path for growth. Founded through the merger of Willis Group and Towers Watson in 2016, WTW operates in over 140 countries and markets, offering services in risk management, insurance broking, human capital and benefits, and investment consulting.

With a strong focus on data, analytics, and technology, WTW works with organizations of all sizes to improve business performance, manage employee benefits, and design effective compensation and retirement strategies. Its mission is to unlock potential for people and organizations through innovative and sustainable solutions.

H&B Claims Executive

202502973
Al Khobar, Eastern Province, Saudi Arabia
Full time
Description
Managing and processing medical insurance claims, ensuring accuracy, compliance, and timely resolution. This role involves reviewing claim documentation, coordinating with healthcare providers and insurers and addressing client inquiries to deliver efficient and effective claim management.

 

The Role

Client Service & Day to Day Operations
• Accurately review, validate, process and adjudicate medical claims in line with policy terms and company procedures
• Ensure (TAT) turnaround time & delivery to clients
• Communicate with policyholders, healthcare providers, and insurers to resolve claims-related queries
• Provide clear and timely updates on claim status to clients
• Educate clients on policy coverage, exclusions, claims process and requirements
• Prepare and submit reports on claim resolutions and outstanding issues
• Investigate discrepancies and irregularities in claims
• Handle disputes and resolve issues
• Collaborate with Senior Claims Manager for specialized cases

Operational Risk

• Maintain detailed and organized records of claim activities
• Implement control procedures
• Ensure implementation of WTW standards
• Follow WTW process and responsible for own results
Organization, People & Stakeholder Management
• Serve as appoint of contact for queries from clients, insurers and internal teams
• Collaborate with departments and maintain process efficiency
• Build successful relationships with employees, clients and insurers

Business Improvement & Operational Excellence
• Implement process quality within the turnaround time
• Identify areas to enhance the process
• Embed and promote a continued improvement environment

Qualifications
The Requirements

• Postsecondary education
• IFCE certification
• Min. 2 years working experience at similar role
• Excellent proficiency in both English and Arabic
• Proficiency in Microsoft Office (Excel, Word, PowerPoint).
• Client-oriented, innovative and critical sense
• Problem-solving and solution-oriented
• Good presentation and negotiation skill

“Official Job Source:“ [H&B Claims Executive]

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