medical claims manager

Wood

<div><p>Wood is currently looking to recruit for a Claims Manager on ADNOC Gas EPCm project based in Abu Dhabi, UAE. #LI- OilandGasJobs #LI-EnergyJobs #LI- UAEJObs #LI- WorkinUAE #LI- EngineeringCareers
</p><p><b>Remarkable people, trusted by clients to design and advance the world.
</b></p><div><p><b>Our Clients and Projects
</b></p></div><div><p><b>Designing the future. Transforming the world.
</b></p></div><div><div><p>Across EMEA, our teams are providing solutions and expertise to support our growing client base, focused on combining maintenance and operations with asset management, modifications and engineering services across the energy and materials markets.
</p></div><div><p>We are focused on growth and our strategy is centered around building partnerships with our clients across the three regions: UK, Norway and the Middle East and Africa.
</p></div><div><div><p><b>What we can offer
</b></p></div><div><ul><li><b>Meaningful and interesting projects: </b>Delivered to high profile clients across the Energy Sector
</li></ul></div><div><ul><li><b>Commitment to Diversity and Inclusion: </b>We are an organization actively committed to diversity and inclusion across our business
</li></ul></div><div><ul><li><b>Competitive renumeration package: </b>With regular reviews to ensure we are rewarding at the right level in line with the market
</li></ul></div><div><ul><li><b>Medical Insurance: </b>Ensures inpatient, and outpatient medical care is available should you require treatment
</li></ul></div><div><ul><li><b>Group Life and Personal Accident Insurance </b>: The company provides Life Assurance cover
</li></ul></div><div><ul><li><b>End of Service Gratuity: </b>In line with UAE Labor Law, all employees are eligible for an End of Service benefit
</li></ul></div></div><div><div><ul><li><b>The Employee Share Plan </b>: Gives you the opportunity to purchase Wood shares and receive a match from the company
</li></ul></div><div><ul><li><b>Long Service Award: </b>Wood values the commitment and loyalty of our people. Celebrating Long Service provides an opportunity for the business to demonstrate their appreciation of the hard work, dedication and many years&rsquo; services of our employees at 5-year service milestones
</li></ul></div><div><ul><li><b>Commitment to continued professional development: </b>Development plans that are tailored to your individual needs and interests
</li></ul></div><div><ul><li><b>Global connections </b>: Join experts around the world who are at the leading edge of our industry, shaping the standards of our profession
</li></ul><div><ul><li><b>Energy Transition Academy: </b>Join a community of experts sharing your knowledge and gaining more exposure to a variety of existing and emerging energy systems &ndash; delivered by experts in their field</li></ul></div></div></div></div></div>
<br><div><div>Wood is a global leader in consulting and engineering, helping to unlock solutions to critical challenges in energy and materials markets. We provide consulting, projects and operations solutions in 60 countries, employing around 35,000 people. www.woodplc.com<br>
</div><div></div><br>
<div><b>Diversity Statement
</b></div><div>We are an equal opportunity employer that recognises the value of a diverse workforce. All suitably qualified applicants will receive consideration for employment on the basis of objective criteria and without regard to the following (which is a non-exhaustive list): race, colour, age, religion, gender, national origin, disability, sexual orientation, gender identity, protected veteran status, or other characteristics in accordance with the relevant governing laws.</div></div>
<br><div><div><p><b>Skills And Qualifications
</b></p></div><div><p><b>What makes you remarkable?
</b></p></div><div><p>At Wood, we are committed to equal opportunities and welcome all talented individuals to consider joining our team. So even if you don't match every statement below but feel you have some of the experience, knowledge or skills needed for this role, we encourage you to apply. It will take all of us working together to deliver solutions to the world&rsquo;s most critical challenges.
</p></div><div><p><b>Expected:
</b></p><ul><li>Extensive Project Commercial Management Experience: The ideal candidate will have +25 years of proven experience in commercial management of large-scale engineering / construction contracts in the oil and gas industry.
</li><li>Contractual Knowledge: In-depth understanding of post-award contract management, including compensation models, risk mitigation, change management and dispute resolution.
</li></ul><p>Educational Background
</p><ul><li>Preferred Qualifications: Bachelor&rsquo;s degree in Quantity Surveying (QS), Engineering, Business, or Law.
</li></ul><p>Key Competencies
</p><ul><li>Leadership and Influence: Strong presence and the ability to lead without direct authority, fostering effective teamwork and collaboration across project teams.
</li><li>Flexibility: A mindset of proactively contributing as required to support the achievement of team goals.
</li><li>Communication: Strong communication skills, with the ability to influence, negotiate, and collaborate effectively across all levels of the organization.
</li><li>Organization and Detail-Oriented: Exceptionally organized, with a keen eye for detail and a methodical approach to managing tasks and coordinating resources.
</li><li>Problem Solving and Resilience: Ability to remain calm and decisive under pressure, adapting to project needs and evolving situations.
</li><li>Relationship Building: Skilled at building and maintaining relationships with project stakeholders, from client representatives to senior project and company leadership.</li></ul></div></div>
<br><div><p><b>Key Accountabilities and Responsibilities:
</b></p><ul><li>The Claims Manager reports directly to the Commercial Manager and is responsible for managing the full lifecycle of contractual claims within an EPCm framework. This dual role includes responding to subcontractor-originated claims directed at the client and proactively safeguarding EPCm Contractor&rsquo;s commercial interest by initiating / supporting claims against the client.
</li><li>The Claims Manager will deliver post-award contract management aligned with our Framework for Managing the Fundamentals (FMF).
</li><li>The Claims Manager may supervise others within the Commercial team.
</li></ul><p><b>Key Responsibilities
</b></p><p>Post-Award Contract Administration
</p><ul><li>Assessment of subcontractor variations / claims and resolution of disputes in accordance with the EPCM Construction Contract and EPCM Agreement.
</li><li>Management of Change, (MOC): A critical element of the role is to work closely with the Commercial Manager and MOC Engineer to identify and assess the impact of potential changes and raise variations to the EPCm Contract.
</li><li>Compliance Oversight: Manage contract administration in line with our existing policies/procedures to ensure strict adherence to contract terms, including initiating notices and reviewing guarantees / insurances.
</li><li>Contractual Correspondence: Working with SubContract Managers and actively managing contractual letters with EPCM Construction Contractors.
</li><li>Close monitoring of Subcontractor reports and maintenance of records in support of change requests.
</li></ul><p>Risk Management
</p><ul><li>Work with Commercial Manager and Risk Manager on identifying key contractual risks with the EPCM Construction Contractors and establishing quantum.
</li><li>Provide regular updates on potential changes / claims / disputes for management reporting and controls.
</li></ul><p>Financial and Cash Flow Management
</p><ul><li>Pro-actively keep commercial and finance teams apprised of current and emerging commercial issues - for payment and cashflow purposes.
</li></ul><p>Project Monitoring and Reporting
</p><ul><li>Stakeholder Reporting: Provide input into regular reports for senior management.
</li></ul><p>Project Oversight and Supervision
</p><ul><li>Team Supervision: Where appropriate, supervise team members, ensuring effective contract management, administration, and resource allocation.</li></ul></div>

Claims Manager

CES, LLC

<div><b>Job Description</b> <b>Summary:</b><br>
The Claims Analyst ensures the review and analysis of sampled Medicaid claims using associated medical records; makes payment determinations based on coverage, coding, utilization of services and practice guidelines; and makes medical necessity determinations utilizing clinical review judgment in accordance with the PERM Program policies and contract responsibilities. The period of performance for this role is from 12/1/2025-3/15/2026.<br>
<br>
<b>Duties/Responsibilities:</b><br>
<ul><li>Conducts in-depth claims analysis utilizing ICD-9-CM, ICD-10-CM, CPT-4, APR-DRG, and HCPCS Level II coding principles</li>
<li>Conducts medical record audits to determine the medical necessity and/or appropriateness of medical treatment as defined by the Statement of Work and CMS directives as well as State specific regulations pertaining to Medical necessity</li>
<li>Reviews the Master Policy List and the MR questionnaire and develops State Fact Sheets and Resource Page for each assigned State prior to the review of claims for that State</li>
<li>Functions as the policy and regulation expert in assigned states</li>
<li>Provides electronic documentation of findings and conclusions with determinations of claims payment appropriateness in review tool fields</li>
<li>Reviews and completes the required number of claims reviews in accordance to established production standards for the project</li>
<li>Communicates internally with all levels of PERM staff</li>
<li>Attend assigned State meetings</li>
<li>Participates in QA and IRR monitoring as requested</li>
<li>Complies with departmental policies and procedures</li>
<li>Comply with QA benchmarks established by the PERM MR department</li>
<li>Attends departmental and required education and training programs</li>
<li>Performs other projects or duties as assigned by the Senior Medical Review Specialist</li>
</ul>
<br>
<b>Required qualifications/skills:</b><br>
<ul><li>Graduate from an accredited Registered Nurse (RN) school (associate degree or diploma based) or Bachelor's Degree (preferred) with active state licensure in one or more of the 50 states or D.C.</li>
<li>Ability to comprehend medical policy and criteria to clearly articulate health information</li>
<li>Team-oriented and able to implement the operational strategies and procedures that will help achieve the overall quality and production goals of the Medical Review unit</li>
<li>Knowledge of ICD-10-CM and CPT-4 coding</li>
<li>Minimum three years of experience in a clinical setting with experience evaluating medical necessity of services, diagnosis and procedure coding and appropriateness of clinical settings.</li>
<li>Inpatient Interqual/Milliman screening or similar product experience preferred</li></ul></div>

Medical Claims Analyst (RN)

PlaceUp

<div><p><b>Location: </b>DIFC</p><p></p><p><b><br>
Role Overview</b></p><p>
We are seeking an experienced and detail-oriented Claims Manager to lead and oversee the end-to-end claims management process across our insurance and reinsurance portfolios. The ideal candidate will possess a deep understanding of claims handling, reinsurance recoveries, policy interpretation, and regulatory compliance, ensuring fair and efficient claim resolutions.</p><p></p><p><b><br>
Responsibilities</b></p><ul><li>
Lead the claims function and ensure timely, fair, and compliant settlement of all claims</li><li>
Oversee claims registration, assessment, negotiation, and payment across all lines of business</li><li>
Review policy wordings, endorsements, and treaty terms to determine coverage applicability</li><li>
Liaise with reinsurers, brokers, adjusters, and legal advisors to manage complex and high-value claims</li><li>
Monitor reinsurance recoveries and ensure accurate reporting of ceded claims</li><li>
Develop and maintain claims procedures, documentation standards, and internal controls</li><li>
Analyze claims trends and loss ratios to support underwriting and risk management teams</li><li>
Supervise claims staff, providing technical guidance and performance management</li><li>
Ensure regulatory compliance with local insurance authorities and international standards</li><li>
Prepare management reports on claim reserves, outstanding losses, and performance metrics</li><li>
Drive continuous improvement and digitalization of claims handling processes</li></ul><p></p><p><b><br>
Requirements</b></p><ul><li>
Bachelors degree in Insurance, Risk Management, Law, or a related field</li><li>
7 - 10 years of experience in claims management within insurance or reinsurance (property, casualty, or specialty lines)</li><li>
In-depth knowledge of policy wordings, reinsurance treaties, facultative placements, and recovery procedures</li><li>
Strong analytical, negotiation, and decision-making skills</li><li>
Familiarity with claims systems (Guidewire, SICS, or equivalent)</li><li>
Excellent communication and stakeholder management abilities</li><li>
Strong leadership and team development skills</li><li>
Professional qualifications (ACII, CPCU, or equivalent) preferred</li></ul></div>

Allianz

<p>Assist in managing and leading a team of claims adjusters.</p><p>Act as a liaison between the Claims Manager and the claims team, ensuring clear communication and alignment of objectives.</p><p>Step in for the Claims Manager during absences, maintaining continuity of leadership and operations.</p><p>Assist the Claims Manager in the development and implementation of departmental strategies and goals.</p><p>Provide regular updates and reports to the Claims Manager on team performance, claims processing, and customer satisfaction.</p><p>Participate in strategic planning sessions and contribute to decision-making processes.</p><p>Provide guidance, training, and mentorship to team members to enhance their skills and performance.</p><p>Monitor team workload and ensure equitable distribution of tasks.</p><p>Review complex or escalated claims and provide guidance on claim determinations.</p><p>Resolve escalated customer inquiries and complaints regarding claims issues.</p><p>Analyse claims data and performance metrics to identify trends and opportunities for process improvement.</p><p>Prepare and present reports on claims activities, outcomes, and key performance indicators (KPIs) to senior management.</p><p>Utilize data analysis to drive strategic decision-making and optimize claims processes.</p><p>Actively participate in various operational activities, outside of claims, to ensure that operational service delivery is coordinated to meet and exceed clients' expectations.</p><p>Assist in developing and updating claims policies and procedures.</p><p>Ensure team adherence to all regulatory and company guidelines.</p><p>Prepare and present regular reports on claims activity, performance metrics, and trends.</p><p>Analyse data to identify areas for improvement and implement corrective actions.</p><p>Other Ad hoc duties as require</p>

Assistant Claims Manager

SD (Middle East) LLC

<div><b>Together, we make the difference.
</b><p>We are a leading provider of innovative, high-performance solutions for airport logistics. Our portfolio includes advanced baggage and cargo handling systems, digital logistics software, and a full range of maintenance and support services. Our clients include some of the world&rsquo;s most renowned airports and airlines.</p>
<p>
Join our dynamic Legal and Compliance team as a <b>Contracts and Claims Manager, </b>based in Dubai, UAE. This role offers the opportunity to work on high-impact projects across the region, with flexibility to travel and support operations in KSA when required.</p>
<b>What are my responsibilities?</b>
<ul><li>Review and analyze contract terms and conditions with customers and main subcontractors.</li>
<li>Identify contractual risks, opportunities, potential claims, and obligations.</li>
<li>Support project teams in understanding, interpreting, and applying contractual provisions.</li>
<li>Safeguard the company&rsquo;s contractual entitlements through timely notifications and proper documentation.</li>
<li>Manage all claim-related activities, including correspondence, substantiation, and negotiation within the project scope.</li>
<li>Promote awareness of claim strategies and their operational implementation among project stakeholders.</li>
<li>Formulate and prepare incoming and outgoing claims in coordination with relevant project team members.</li>
<li>Maintain an up-to-date register of all claims, events, and contract documentation.</li>
<li>Support the procurement department in drafting and reviewing contractual documents.</li>
<li>Assist in reviewing tender documents and contracts to identify key terms, obligations, and potential risks.</li>
<li>Prepare clarifications and queries to clients during the tender stage.</li>
</ul><b>What do I need to qualify for the role?</b>
<ul><li>Bachelor&rsquo;s degree in Engineering (any field) or a Commercial degree &mdash; ideally with specialization in Business Law, LLM, or similar.</li>
<li>Minimum of 5 years&rsquo; experience in EPC projects within the Middle East region.</li>
<li>Solid understanding of contract structures, terms and conditions, and related legal implications.</li>
<li>Proven familiarity with FIDIC and other standard contract forms.</li>
<li>Experience in delay analysis and time extension claims.</li>
<li>Proficient in MS Word, Excel, and PowerPoint.</li>
<li>Working knowledge of project planning and scheduling concepts.</li>
<li>Strong written and verbal communication skills.</li>
<li>Analytical mindset with excellent attention to detail.</li>
<li>Effective team player with collaborative approach.</li>
<li>Fluent in English.</li></ul></div>

Contracts and Claims Manager

Suncorp

<p>Take the next step. Be part of something bigger at Suncorp.</p><ul><li><b>Contract Role: </b>Commencing 24 November 2025 until 29 April 2026</li><li><b>Hours: </b>Full-time, Monday-Friday (rotating roster 8am-6pm)</li><li><b>Salary</b>: $79,500 inclusive of 12% super</li><li><b>Training:</b> 5-week structured program</li></ul> <b>What It's Really Like to Be a Claims Manager at Suncorp</b> <p><b>As a Claims Manager, people think I just manage claims. But what I really do is help people on some of the worst days of their lives - and we're looking for others who are just as passionate about making a difference.</b></p><p>When storms hit or fires break out, our phones ring. I could be speaking to someone whose home is underwater, whose roof has collapsed, or who's just lost everything. It's not easy, but it's real, human work, that matters - because customer obsession is at the heart of everything we do.</p><p>I joined Suncorp because I wanted to make a difference. What I found was a role where I'm challenged every day, backed by a team who truly gets it, and supported by leaders who check in, especially after the tough calls.</p><p><b>What I Do as a Claims Manager:</b></p><p>No two days are ever quite the same, but here's what you can expect:</p><ul><li><b>Listen, really listen:</b> I speak with customers who are often overwhelmed or vulnerable. I give them the space to be truly heard, because customer obsession starts with understanding.</li><li><b>Be a calm, steady guide</b>: I walk them through what's covered in their policy, what will happen next, and make the complex feel simple.</li><li><b>Balance heart with policy:</b> I make fair, transparent decisions that respect both the customer's situation and our guidelines.</li><li><b>Keep things moving:</b> I manage my own portfolio of claims end-to-end, making timely decisions and keep things moving, especially during busy times.</li><li><b>Solve problems</b>: Every customer's situation is different. I think critically and creatively to find the best way forward, especially when things don't go to plan.</li><li><b>Stay on top of the detail:</b> I document everything accurately, it's how we stay accountable and ensure customers feel confident in the process.</li><li><b>Lean on your team:</b> Some calls are challenging, but I'm part of a supportive group who debrief together, check in, and keep things human.</li></ul><p><b>What You'll Bring:</b></p><p>This isn't a script-reading call centre job. It's fast-paced, emotionally complex and deeply human.</p><p>You'll do well here if you bring:</p><ul><li><b>Compassion: </b>A calm, compassionate voice that brings reassurance, even in tough conversations</li><li><b>Resilience: </b>Emotional resilience with the ability to manage your wellbeing and stay grounded</li><li><b>Confidence: </b>Confidence to make clear, fair decisions and communicate them with clarity</li><li><b>Detail-Focused: </b>Sharp attention to detail paired with the skill to balance multiple priorities</li><li><b>Empathy: </b>Genuine empathy and care for customers navigating challenging times</li><li><b>Growth Mindset: </b>Experience in customer service, claims, insurance, or fast-paced environments is valued, but what matters most is a growth mindset and passion to make a real difference</li><li><b>Work From Home Setup:</b> Reliable internet & ergonomic desk and chair. Laptop & headset will be provided.</li></ul><p><b>What's in it for you:</b></p><ul><li><b>Hours:</b> Full-time, Monday to Friday (rotating roster between 8am-6pm) - contract role until 29 th April 2026.</li><li><b>Location:</b> Hybrid working - just two days a week in the office</li><li><b>Salary:</b> $79,500 inclusive of 12% super</li><li><b>Training:</b> Five weeks of structured, supportive training, setting you up to succeed and grow from day one.</li><li><b>Equipment:</b> Laptop and headset will be provided.</li><li><b>Support:</b> Leaders who genuinely care, real-time coaching to help you shine, access to Employee Assistance Programs, and a kind, capable team that has your back.</li></ul><p><b>Why I Stay:</b></p><p>This job isn't for everyone. You need thick skin and a big heart. You'll have days where the calls are tough, and you feel stretched. But if you're someone who finds purpose in helping people when it really counts, you'll find this role incredibly fulfilling.</p><p><b>We're hiring now. If this speaks to you, apply today.</b></p><p>And if you're unsure? Apply anyway, we'd love to speak with you. Some of the best Claims Managers here had no idea they'd be good at this, until they gave it a go.</p><p>For more information, please contact our delivery partners on .</p><p>At Suncorp, we are committed to building futures and protecting what matters. We value the unique experiences, insights and diverse workforce that benefits our people, our business, and our customers. We'd love to see your application and speak with you even if you do not match the above mentioned.</p><p><b>Advertised:</b> 29 Oct 2025 AUS Eastern Daylight Time<br/><b>Applications close:</b> 09 Nov 2025 AUS Eastern Daylight Time</p><p>Don't see your dream job posted? No problem, sign up for job alerts and we'll let you know once something becomes available.</p>

Leading Edge

<p><b>Job Title: Motor Claims Manager</b><br/>Location: Riyadh<br/>Contract: 3-6 months (extendable)</p> Overview <p>Our client, a top-tier insurer in Saudi Arabia, is hiring a Motor Insurance Claims Expert to lead cost-saving initiatives and optimize average claim costs.</p> Responsibilities <ul><li>Drive cost-reduction and benefit realization initiatives.</li><li>Optimize average motor claim costs and settlement frameworks.</li><li>Apply regional and international best practices in motor claims.</li><li>Work with actuarial, operations, and finance teams.</li><li>Handle motor insurance policies, including quotations, issuance, and renewals.</li><li>Conduct risk assessments and policy reviews.</li><li>Contribute to developing and launching new motor insurance products.</li></ul> Requirements <ul><li>Motor claims operations and claims analytics & cost control.</li><li>2+ years in the motor insurance industry, with exposure to GCC or international insurance markets.</li><li>Excellent customer service, communication, and analytical skills.</li><li>Proficiency in Arabic and English.</li></ul>

Motor Claims Manager

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