Approval Officer NMC Royal Womens Hospital Abu Dhabi

An Approval Officer at NMC Royal Womens Hospital will evaluate the Pre Approval requests from medical necessity for the requested service according to the medical data provided. He will accurately code the service description codes stated on the prior authorization requests, according to accepted medical coding rules, medical guidelines and policy’s schedule of benefits.

Duties as Approval Officer

• Respond to Insurance/ TPA queries and liaise with concerned department without any delay.
• Responsible for receiving, evaluating and escalating second opinion cases and case management.
• Perform night shift duty and on public holidays as per duty roster.
• Prepares reports of daily activity as requested for management and assists management in monthly reports as requested.
• Handle Auditing Process. Arrange required documents and papers and check with coders in order to assist the external Auditors.
• Attend Meetings and Presentation
• Train Front office, Receptionist and Nurses and keep them updated about Insurance details.
• Prepare cost estimate for procedures for Cash Patient.
• To adjust duties in case of any sudden/ emergency unplanned leaves by colleagues.
• Managing and handling pending cases (if any) to the next shift colleagues.

Education & Experience

Following is the eligibility criteria for the role of Approval Officer at NMC Royal Womens Hospital:

• Bachelor Degree in Medicine (MBBS) graduate from a recognized university.
• Experience in Insurance Claims management/adjudication (minimum 2 years).

Approval Officer NMC Bareen International Hospital Abu Dhabi

Specialist Gastroenterologist NMC Building Sharjah

Orthopedic Surgery Specialist NMC Healthcare UAE