Legal Representative/ Compliance Manager
Vinnell Arabia
Total des années d'expérience :31 years, 2 Mois
Guarantee and work on that all company’s policies, transactions and operations comply with the Saudi Arabia laws and provisions, while actively helping the company avoid possible legal risks and violations and handling lawsuits.
Update company work regulations policy IAW Saudi Labour Law and Ministry of Human Resources & Social Development; Conduct or direct internal investigation, coordinate to have employees summon to appear before the investigation committee for conducting a disciplinary meeting. Recommend of disciplinary actions issuance.
1. Identifying compliance issues that require follow-up or investigation.
2. Conduct or direct the internal investigation related to legal misconduct.
3. Advise Human Resources department on disciplinary meetings and make recommendations on appropriate disciplinary actions.
4. Prepare the appropriate legal documents for trial or court proceedings; structure, draft and review reports and other legal documents.
5. Represents the company in legal matters before governmental agencies and court proceedings.
6. Assist in the development, monitoring and improvement of the company policies, practices, and programs.
7. Examine the legal issues related to new activities and services of the company
8. Assure company operations comply with the provisions applicable law and advise the company on legal rights and duties.
9. Research, anticipate and protect the company against legal risks and violations.
10. Provides advice and assistance on legal matters to company departments and divisions.
11. Assist on draft and administer of contracts.
- Understand the current trends in the health care system to make well-informed decisions.
- Compile, analyze and validate the crucial medical data needed by the company and insight better improve healthcare systems.
- Identify the potential risks that are present for the company based on their location and their dealings and then recommend the best Medical Insurance policy that will reduce risk.
- Determine what risks are involved for various lines of Health insurance and then how these risks should impact premiums and how much is due to bind the coverage.
- Conduct interviews to establish and maintain satisfactory working relationship with insurance industry to analyze hence to develop a method for: gathering of facts, information/data criteria of treatment.
- Develop initiatives for providing more effective health care and resolve current service issues. Acquire and maintain subject matter expertise of government health insurance laws including CCHI, SAMA and GOSI.
- Knowledge of the Insurance rules, regulations and procedures pursuant thereto, particularly as related to policy evaluations, license and complaint resolution.
- Advise and respond to complex inquiries and work related injuries (STD & LTD) insurance, coverage provisions of plans, appeals with health insurers.
- Manage multiple policies, as well as meet time constraints and expectations.
- Manage all aspects of members’ health insurance (i.e., determine eligibility, set up deduction, enrolling, changing of status).
- Review and analyze written correspondence received by members, determining status (complaint or inquiry) and process through the electronic system for handling by an assigned insurer.
- Review claims and analyze the potential risks an applicant will present or whether or not the claim is legitimate or fraud.
- Review the details surrounding the claim and conduct an investigation, such as visiting to the medical provider, interviewing medical staff, and working with law enforcement professionals.
Duties/Responsibilities:
1- Supervise on Identifying compliance issues that require follow-up or investigation.
2. Conduct or direct the internal investigation, disciplinary meetings and issuance of disciplinary actions.
3. Coordinate with managers in any employees issues and provide them with the right guidance in compliance with Saudi labor law.
4. Assist Manager, ERB with administration work and provide reports.
5. Supervise on Handling complaints of employees, termination requests, and poor rating of Employees Performance Appraisal Cases.
6. Supervise on Preparing final compensation reports, and handing Saudi Labor Law Cases.
7. Assist in the development, monitoring and improvement of HR policies, practices and programs.
8. Ability to obtain and maintain the HR certification.
• Contribute to the management of medical operations of the unit, oversee accounting aspects of treatment, health insurance, hospital admittance procedures, and discharge formalities for members receiving treatment at approved hospitals.
• Receive study and organize medical claims, provide detailed analysis of medical claims for further processing based on eligibility norms and organizational rules, and forward investigation reports to the management.
• Receive study and organize medical claims, provide detailed analysis of medical claims for further processing based on eligibility norms and organizational rules, and forward investigation reports to the management.
• Study government claims, submit analysis to the management to evaluate applicability and enable decision-making.
• Oversee the management of AR (Accounts Receivable) and AP (Accounts Payable), expedite receipts from government agencies, institutes and established clients, and ensure availability of adequate cash to maintain liquidity.
• Enter into contracts with hospitals, insurance companies and healthcare service providers to arrange medical facilities for SANG and secure adequate insurance cover for members of the unit; ensure adherence to contractual terms and conditions.
• Make necessary arrangements for the provision of healthcare facilities across the unit, register member details at hospitals and with insurance service providers, and ensure authentication of unit members as per prescribed practices.
Independently audit accounting records of the unit’s medical operations, verify fulfilment of contract terms, evaluate services provided by hospitals and insurance companies during medical emergencies and submit detailed findings to the management.
• Invited RFQs (Request for Quotation) from eligible subcontractors, received and examined quotations sent by interested parties and approached suitable entities for further discussion, negotiation and contract finalization.
• Liaised with medical subcontractors to secure medical equipment, hospital and pathology apparatus as per the agreed terms & conditions.
• Ensured compliance with the recommended health and safety standards based on western medical & healthcare specifications and conducted research to integrate new developments with the existing procedures.
• Monitored adherence to quality parameters and delivery lead times, and submitted subcontractor performance reports to the management.
• Scrutinized subcontractor invoices, assessed correctness of bills based on fulfillment of contractual obligations and forwarded invoices for payment processing to the accounting department.
• Maintained records and created separate files for every subcontractor on-board, ensured complete documentation and logged in subcontractor details along with information of transactions in the internal system.
Responded to business inquiries from prospective medical subcontractors, explained company policy and terms of contract, and filed details of all inquiries received for future reference.
English Language Skills, Specialized Medical Terminology:
• At Allied Health Sciences Military School, imparted courses to develop skills in Basic English
and designed the English language module for Faculty Development Programs (FDPs) held at
the School.
• Trained the staff on “Specialized Medical Terminology” applicable in different fields of medical
science, assisted the staff in comprehending technical terms, instructions for use of medical
equipment, etc. and answered corresponding queries.
• Translated coursework from English to Arabic as required and handled additional translation
duties to provide interpretation of official correspondence and executive communication with
Saudi Arabian National Guard (SANG) and other departments across the organization.
• Developed interesting lessons and presentations to communicate with the staff and held
interactive sessions to encourage exchange of information; provided key inputs based on
changes seen globally.
• Assigned desk research on specific topics and themes to the staff, assisted in the completion of
assignments and evaluated progress on completion of each activity in theory &practice.
• Worked in close collaboration with the Chief Trainer - Health Sciences Faculty Development, to
communicate changes required in the existing coursework, provided data-backed reports to
incorporate new concepts, theories and best practices emerging in the field of medical science,
healthcare and hospital management.
• Conducted mock classes to evaluate the skills gained by the staff in delivering lessons to pupils
enrolled in the School, fine-tuned teaching methodology as required and provided constructive
feedback to the teaching staff.
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• Handled formalities for registering and admitting emergency cases at the hospital, completed
documentation & paperwork as mandated by statutory laws and coordinated appointments for
external doctors, anaesthetists and medical experts visiting the hospital.
As part of Medical & Clinical Operations department at King Faisal, assisted senior personnel in
administration, recorded hospital case acceptance papers and maintained office records,
documents and files.
• Provided necessary information and support to patients and their families, explained treatment
methods and procedures, expenditure involved, adequacy and scope of medical insurance, and
formal procedure to avail medical insurance facilities.
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- Human Resources and Executive Management support.
- Contract Drafting and Legal Interpretations.
- Oracle HRMS (People Management and Payroll).
Medical Unit Assistant
مساعد وﺣﺪة ﻃﺒﻴﺔ
King Fahad Hospital for National Guard
Telephone Operator and Public Relations officer
مأمور ﺳﻨﺘﺮال و ﻋﻼﻗﻼت ﻋﺎﻣﺔ
Royal Telecom Administration, Ministry of PTT
June, 1992 - July, 1997، Saudi Arabia
2018 ﻗﺴﻢ اﻟﻘﺎﻧﻮن - كلية العلوم و الدرراسات اﻟﻨﻈﺮﻳﺔ - الجامعة السعودية الالكترونية
the field of English / Arabic