- 経験
- 2年以上
- 給料
- —
- 求人情報
- 1
- 投稿済み
- 1週間前
- 作業モード
- 在任中
- 教育
- 工学士
- 資格
- Pharmacists or pharmaceutical science graduates with at least 2 years of relevant experience and an Insurance Foundation Certificate.
- 再開する
- 応募必須
勤務地
仕事内容
About My Clinic
My Clinic is a multispecialty outpatient care provider in Saudi Arabia that has been serving patients since 2017. The organization focuses on helping people live longer, healthier, and happier lives, and it emphasizes innovation, collaboration, ambition, and responsibility as part of its culture and growth journey.
Role Overview
The Insurance Pharmacist will support pharmacy operations by managing insurance-related queries, coordinating approvals, and ensuring medication claims align with CHI policies, medical justification, and updated insurer guidelines. This role also includes working with patients, insurers, and internal pharmacy teams to improve claim outcomes and maintain accurate insurance and formulary information.
Key Duties
- Provide backline support to pharmacists when insurance-related questions or issues arise.
- Track rejected pre-authorization requests and work on resubmission or approval when the case is covered under CHI policy and medically justified.
- Communicate directly with insurer physicians and representatives to secure approval for medications.
- Manage cases where pre-authorization requests were missed and take the required follow-up actions.
- Stay current with changes in insurance policies and medical guidelines so exceptions and extra rules can be applied quickly and accurately.
- Assist patients in understanding their insurance coverage and respond to insurance-related questions.
- Revise the list of non-covered medications in line with new CHI rules and the varying policies of insurance providers.
- Maintain and update drug formulary classification based on the latest SFDA IDF drug list to support the correct CHI deductible process.
- Train frontline pharmacists and keep them informed about insurance procedures and updates.
- Analyze rejected medication claims to identify patterns and help reduce future claim rejections.
- Carry out additional professional tasks assigned by the line manager.
Education and Experience
Candidates must hold a bachelor’s degree in pharmaceutical science, have at least 2 years of experience in the same field, and possess an Insurance Foundation Certificate.
Additional Information
This is a full-time, onsite position in Jeddah, Makkah, Saudi Arabia.