Approval Officer Job in Dubai Full Time

We’re looking for a dynamic Approval Officer to join our team in Dubai. This role involves applying your medical expertise and understanding of insurance best practices to review and verify Pre Approval requests (both OP/IP) from various departments. Your goal will be to secure necessary authorizations based on insurance plan coverage for our insured patients. You’ll ensure that these requests align with regulatory standards, including claim adjudication and business rules.

Key Responsibilities Approval Officer:

•  Assess Pre Approval requests for medical necessity, using the provided medical data. Accurately code service descriptions according to medical coding standards, guidelines, and policy benefits.
•  Promptly respond to queries from Insurance/TPA and coordinate with relevant departments.
•  Manage the evaluation and escalation of second opinion cases and case management.
•  Commit to night shifts and working on public holidays as per the duty roster.
•  Generate daily activity reports and assist in monthly reporting for management.
•  Oversee the Auditing Process, including document preparation and collaboration with coders for external audits.
•  Participate in meetings and presentations.
•  Conduct training for Front Office staff, Receptionists, and Nurses on insurance details.
•  Prepare cost estimates for procedures for cash-paying patients.
•  Adapt to sudden or emergency changes in staffing.
•  Ensure smooth handover of pending cases to colleagues in the next shift.
•  Undertake additional tasks as assigned by the Head of Department within the job scope.

Qualifications:

•  A Bachelor’s degree in medicine (MBBS) from a recognized university.
•  At least 2 years of experience in Insurance Claims management/adjudication.
•  Proficiency in Medical Coding (ICD, CPT, DRG, HCPCS).
•  Excellent command of both spoken and written English.
•  Ability to work flexibly and handle pressure well.
•  Strong skills in Microsoft Office applications.

Join our team now