Insurance Pharmacist

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My Clinic , the leading multispecialty outpatient care provider in Saudi Arabia, where our mission to help people live longer, healthier, and happier lives drives everything we do. Since 2017, we’ve been at the forefront of healthcare, combining innovation with a deep commitment to care, collaboration, ambition, and responsibility. As we continue to grow and reach new heights, we’re looking for passionate individuals who share our vision and values.

Job Responsibilities

Work as a back line support with pharmacists to help them if they have any insurance queries.

Follow up the rejected pre‑authorization requests and process them to get approval if the request is covered by CHI policy and medically justified.

Communicate directly with insurance companies’ doctors and delegates to gain approval for medications.

Manage and handle the missed pre‑authorization requests.

Keep updated with new insurance company policies and medical guidelines to apply exceptions or additional rules, enabling fast decisions and approvals.

Work with patients to help them understand their insurance coverage and answer any related queries.

Update the list of not covered medications according to CHI new rules and insurance companies’ different policies.

Update the drug formulary classification according to the updated IDF of SFDA drug list to correctly implement the new deductible policy of CHI.

Train front line pharmacists and keep them updated about insurance details.

Make data analysis for the rejected medications to avoid the rejection reasons in future claims.

Perform other professional duties requested by line manager.

Education & Professional Qualifications

Education Degree : Bachelor degree in pharmaceutical science.

Years of Experience : minimum of two years’ experience in the same field.

Seniority Level Mid‑Senior level

Employment Type Full‑time

Job Function Other

Industries Hospitals and Health Care

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