NMC Healthcare
Approval Officer
🇦🇪 Abu Dhabi, UAE🏢 On-site
Medical CodingPre-authorizationInsuranceTPACase ManagementMedical Necessity
At a Glance
- Category
- 🏥 Healthcare
- Level
- Mid-Level
- Type
- Full-time
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- Evaluate the pre-authorization 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
- •Ability to evaluate pre-authorization requests based on medical necessity
- •Knowledge of medical coding rules and guidelines
- •Ability to liaise with concerned departments
- •Ability to perform night shift duties
- •Reporting skills for daily and monthly activities
Responsibilities
- •Evaluate pre-authorization requests from medical necessity for requested services
- •Accurately code service description codes according to medical coding rules and policy schedules
- •Respond to Insurance/TPA queries and liaise with concerned departments
- •Receive, evaluate, and escalate second opinion cases and case management
- •Perform night shift duty to sustain authorization department issues and queries
- •Prepare daily activity reports for management
- •Assist management in preparing monthly reports
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- Find the mistakes in your CV before NMC Healthcare sees it
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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.