Contract Specialist
Saudi Fisheries Company
Total years of experience :5 years, 0 Months
-Negotiate contract agreements for products and services.
-Assess contractor performance to identify the need for amendments of existing contracts.
-Prepare and edit contracts between the company and potential clients.
-Handle breach of contracts in a timely manner.
-Serve as the main liaison with outside contracting representatives.
-Develop and implement effective procurement proposals.
-Research regulations to guarantee contracts are updated and in compliance with laws.
-Coordinate with clients to guarantee terms of contracts are fulfilled in compliance with the contract terms and regulations.
Determines covered medical insurance losses by studying provisions of policy or certificate.
Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims.
Documents medical claims actions by completing forms, reports, logs, and records.
Resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
Ensures legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.
Maintains quality customer services by following customer service practices; responding to customer inquiries.
Provides legal support by assembling documentation for settlement action.
Protects operations by keeping claims information confidential.
Prepares reports by collecting, analyzing, and summarizing information.
Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
Accomplishes organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
Gaining an understanding of the claims process through meetings with various claims personnel.
Reviewing selected claims files.
Participating in meetings to determine tasks to be completed for claim investigations.
Performing assigned tasks to help complete claims investigations, to include:
Detailed social media investigation on claimants and other parties involved in specific claims.
Other on-line investigation on claimants and involved parties including educational, employment, recreational and criminal background.
Preparing reports on investigational findings.
Working as an apprentice with a senior claims staff professional.
Performing assigned tasks within the mentors portfolio of claims.
Participating in claims round table sessions to discuss investigation findings, recommendations for additional work and claims evaluation.