Back to all Jobs see more Healthcare jobs

Approval Officer NMC Specialty Hospital Abu Dhabi

  • Full time
  • Abu Dhabi, United Arab Emirates, NMC Specialty Hospital, Abu Dhabi, AE View on Map
  • @NMC Healthcare posted 4 months ago
  • Posted : January 23, 2025 -Accepting applications
  • Salary: د.إ7,000.0 - د.إ15,000.0 / Monthly
  • View(s) 166

Job Detail

  • Job ID 32971
  • Career Level  Intermediate
  • Experience  2 Years
  • Gender  Male Female 

Job Description

Approval Officer at NMC Healthcare in NMC Specialty Hospital, Dubai, UAE will apply medical knowledge and best insurance practice while reviewing and verifying the Pre Approval requests (OP/ IP) received from different departments to obtain authorizations as required by insurance companies dependent upon the plan coverage for all Insurance patients. Ensure that the details of the Pre Authorization Requests are in line with the regulators’ standards especially the claim adjudication Rules and Business Rules. Handling the rejected pre authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval. Prepares reports of daily activity as requested for management and assists management in month end reporting as requested. This is an Intermediate level full time job. And salary can range between 7000-15000 AED/month.

Ad

Responsibilities of Approval Officer

  • Evaluate the Pre Approval requests from medical necessity for the requested service according to the medical data provided and 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
  • Response to Insurance/ TPA queries and liaise with concerned department.
  • Responsible for receiving, evaluating and escalating second opinion cases and case management
  • Perform night shift duty to sustain any issues and queries related to Authorization department
  • Prepares reports of daily activity as requested for management and assists management in monthly reports as requested.

Requirements for Role of Approval Officer

  • Bachelor’s degree in medicine (MBBS) graduate from a recognized university.
  • 2 years of experience in Insurance Claims management/adjudication.
  • Experiences in Medical Coding ICD, CPT, DRG and HCPCS.

Skills And Knowledge Desired

  • Excellent command of oral and written English.
  • Flexible and able to work under pressure.
  • Excellent knowledge of Microsoft applications.

\Registered Nurse OPD NMC Healthcare Sharjah

Required skills

Related Jobs

 
Required 'Candidate' login to applying this job. Click here to logout And try again
 
 
 
 

Apply for this Job

  • Drop a resume file or click to upload.
    To upload file size is (Max 5Mb) and allowed file types are (.doc, .docx, .pdf)
    or
    Upload Resume

  • By clicking checkbox, you agree to our Terms and Conditions and Privacy Policy

 

Account Activation

Before you can login, you must activate your account with the code sent to your email address. If you did not receive this email, please check your junk/spam folder. Click here to resend the activation email. If you entered an incorrect email address, you will need to re-register with the correct email address.