NMC Healthcare
Approval Officer
🇦🇪 Abu Dhabi, UAE🏢 On-site
Medical InsurancePre-AuthorizationClaim AdjudicationHealthcare AdministrationInsurance Rules
At a Glance
- Category
- 🏥 Healthcare
- Level
- Mid-Level
- Type
- Full-time
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- 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.
Requirements
- •Apply medical knowledge and best insurance practices
- •Review and verify Pre Approval requests (OP/IP)
- •Ensure compliance with regulators’ standards and claim adjudication rules
- •Handle rejected pre-authorizations and obtain justifications from doctors
- •Prepare daily activity reports for management
- •Assist management in month-end reporting
Responsibilities
- •Obtain authorizations from insurance companies based on plan coverage
- •Verify details of Pre Authorization Requests against business rules
- •Liaise with treating doctors to resolve rejected requests
- •Submit resubmissions to insurance companies to obtain approvals
- •Generate daily and monthly reports
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Are You Getting Through?
- Find out if software is throwing out your CV before NMC Healthcare reads it
- Get every weak line rewritten
- Download a CV written for the Gulf
Free check in 60 seconds. Fixes $5.88 one-time, only if you want them.
GCC Info
Company
NMC Healthcare
5000+ employees
NMC Health is one of the largest private healthcare providers in the UAE. It operates hospitals, day surgery centers, and clinics across the country.