19 Health Insurance jobs in Manama

• Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related field.
• Fellow of the Society of Actuaries (FSA) or equivalent credential.
• 7+ years of actuarial experience, with a significant focus on health insurance.
• Proven experience in pricing, reserving, and financial modeling for health products.
• Expertise in healthcare cost trends, risk adjustment, and regulatory requirements.
• Proficiency in actuarial software and statistical analysis tools.
• Excellent analytical, problem-solving, and communication skills.
• Ability to work autonomously and manage complex projects remotely.

• Investigate and analyze complex health insurance claims, including medical records, bills, and policy details.
• Determine coverage eligibility and liability based on policy provisions and applicable laws and regulations.
• Communicate effectively with policyholders, healthcare providers, and other stakeholders to gather necessary information and explain claim decisions.
• Negotiate settlements with claimants and providers when necessary, ensuring fairness and adherence to company guidelines.
• Maintain accurate and detailed records of claim investigations, evaluations, and resolutions within the claims management system.
• Identify potential fraudulent claims and escalate them for further investigation according to established procedures.
• Ensure compliance with all state and federal regulations pertaining to health insurance claims processing.
• Stay informed about changes in medical terminology, coding (e.g., ICD-10, CPT), and healthcare policies.
• Provide guidance and mentorship to junior claims adjusters.
• Contribute to the improvement of claims processing procedures and best practices.
• Manage a caseload of complex claims, ensuring timely and accurate processing from initiation to closure.
• Uphold the highest standards of customer service and ethical conduct.

• High school diploma or equivalent; Bachelor's degree in a related field is preferred.
• Minimum of 5 years of experience in health insurance claims adjusting, with a strong focus on complex cases.
• In-depth knowledge of medical terminology, healthcare billing codes (ICD-10, CPT, HCPCS), and various medical procedures.
• Thorough understanding of health insurance policies, coverage limitations, and legal/regulatory requirements.
• Proficiency in using claims management software and standard office applications.
• Excellent analytical, investigative, and problem-solving skills.
• Strong negotiation and communication skills, both written and verbal.
• Ability to work independently, manage time effectively, and meet strict deadlines in a remote work environment.
• High level of integrity and attention to detail.
• Relevant professional certifications (e.g., FLMI, AIC) are a plus.

• Develop, maintain, and refine pricing models for new and existing life and health insurance products.
• Perform valuation of policy liabilities and reserves, ensuring accuracy and compliance with accounting standards.
• Analyze historical claims data and mortality/morbidity trends to inform pricing and reserving decisions.
• Conduct profitability studies and scenario testing to assess the financial impact of various market conditions.
• Assist in the development of financial projections and long-term strategic plans.
• Collaborate with underwriting, product development, and finance teams to provide actuarial insights and support.
• Stay updated on industry regulations, new actuarial techniques, and best practices.
• Prepare reports and presentations for senior management and regulatory bodies.
• Mentor and guide junior actuarial staff.
• Contribute to the continuous improvement of actuarial systems and processes.

• Bachelor's degree in Actuarial Science, Mathematics, Statistics, or a related quantitative field.
• Successfully passed a significant number of actuarial exams (e.g., SOA/CAS exams) – progress towards Fellowship is highly desirable.
• Minimum of 5 years of experience in actuarial work, specifically within the life and/or health insurance industry.
• Proficiency in actuarial modeling software (e.g., Prophet, GGY AXIS) and statistical analysis tools.
• Strong understanding of life and health insurance products, regulations, and market dynamics.
• Excellent analytical, quantitative, and problem-solving skills.
• Proficiency in programming languages like Python or R is a plus.
• Strong communication and presentation skills, with the ability to explain complex technical concepts to non-technical audiences.
• Ability to work independently and manage multiple priorities in a remote work environment.

We are seeking a highly motivated and experienced Insurance Specialist to join our dynamic team. The ideal candidate will possess a strong understanding of insurance principles and practices, coupled with the requisite certifications to excel in this role.

• Underwriting: Evaluate and assess insurance risks, determine appropriate coverage, and set premiums.
• Claims Processing: Handle and process insurance claims efficiently and accurately, ensuring timely payments and customer satisfaction.
• Policy Administration: Maintain and update policy records, issue policies, and handle renewals and endorsements.
• Customer Service: Provide excellent customer service by addressing inquiries, resolving issues, and educating clients on insurance products and services.
• Compliance: Ensure adherence to regulatory guidelines and industry best practices.
• Product Knowledge: Stay updated on industry trends and product offerings to provide informed advice to clients.

• Education: Bachelor’s degree in business, finance, or a related field.
• Certifications: CII (Chartered Insurance Institute) or LOMA (Life Office Management Association) certifications is mandatory
• Experience: Minimum of (Number) years of experience in the insurance industry.
• Technical Skills: Proficiency in insurance software and systems.
• Soft Skills: Strong communication, analytical, and problem-solving skills.

Job Type: Full-time

Pay: BD BD per month

Education:

• Bachelor's (Required)

Language:

• English (Required)
• License/Certification:
• CII OR LOMA Certificate (Required)

• Reviewing and analyzing insurance applications for various policy types (e.g., life, health, property, casualty).
• Assessing risks associated with each application by examining financial records, medical histories, property reports, and other relevant documentation.
• Determining policy eligibility and coverage limits based on established underwriting guidelines and risk appetite.
• Calculating and setting premium rates that accurately reflect the assessed risks and ensure profitability.
• Utilizing underwriting software and tools to streamline the evaluation process and maintain records.
• Collaborating with insurance agents and brokers to gather necessary information and clarify policy details.
• Staying updated on industry regulations, market trends, and changes in insurance products.
• Identifying potential fraud indicators and escalating suspicious applications for further investigation.
• Developing and recommending improvements to underwriting policies and procedures.
• Providing clear explanations of underwriting decisions and policy terms to relevant parties.

• Evaluate insurance applications and assess risks associated with applicants.
• Determine appropriate coverage terms, conditions, and premiums.
• Adhere to underwriting guidelines, policies, and regulatory requirements.
• Analyze financial statements, medical records, and other relevant documentation.
• Collaborate virtually with brokers, agents, and clients to obtain necessary information.
• Develop and maintain strong relationships with external partners.
• Identify trends and emerging risks within the insurance market.
• Assist in the development and refinement of underwriting manuals and procedures.
• Provide insights into loss prevention and risk management strategies.
• Ensure timely and accurate processing of insurance applications.

• Bachelor's degree in Finance, Economics, Business Administration, or a related field.
• 3-5 years of experience in insurance underwriting.
• In-depth knowledge of insurance products, regulations, and underwriting principles.
• Strong analytical, critical thinking, and decision-making skills.
• Proficiency in underwriting software and MS Office Suite.
• Excellent written and verbal communication skills for remote interaction.
• Ability to work independently and manage time effectively in a remote environment.
• Relevant insurance designations (e.g., CPCU, AU) are a strong asset.
• Experience in a specific insurance line (e.g., life, property, casualty) is beneficial.