Authorization Officer (Tawam Hospital)
At a Glance
- Category
- 🏥 Healthcare
- Level
- Mid-Level
- Type
- Full-time
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The PAVE Representative is responsible for initiating a Pre-Authorization request to the payer for the claims that require approval. This position requires communication with payers, patients, physician offices, and hospital clinical staff. This position is primarily responsible for pre-certifying procedures ordered by physicians. The PAVE Representative will also be responsible for monitoring appropriateness and medical necessity, and providing necessary information for authorization and continued visits. This individual will confirm pre-certifications that have been obtained or will obtain pre-certifications if needed.
Requirements
- •Ability to communicate with payers, patients, and physician offices
- •Ability to coordinate with hospital clinical staff
- •Knowledge of pre-certifying procedures ordered by physicians
Responsibilities
- •Initiate Pre-Authorization requests to payers for claims requiring approval
- •Pre-certify procedures ordered by physicians
- •Monitor appropriateness and medical necessity of procedures
- •Provide necessary information for authorization and continued visits
- •Confirm pre-certifications that have been obtained or obtain new ones if needed
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SEHA is the Abu Dhabi National Health Insurance Company, responsible for public healthcare services in the Emirate. It manages a network of hospitals and clinics.