Medical Authorization Officer Transguard, Abu Dhabi Full Time Permanent Jobs Private Jobs

Transguard  has flourished into a leader across various sectors such as Cash Services, Security Services, Manpower Services, Facilities Management, and Aviation. Renowned for being the UAE’s most reliable business support and outsourcing provider, we pride ourselves on our vibrant, diverse team of over 50,000 employees. We’re on the lookout for an Officer – Medical Authorization to join our esteemed client’s team in Abu Dhabi.

Role Overview as Medical Authorization Officer:

In this pivotal role, you will be the cornerstone of the prior authorization process. Your duties will encompass gathering essential documents, liaising with clients or network providers for additional data, and managing the complete cycle of prior and retro authorization requests to facilitate service processes. .

Your Day-to-Day:

• Uphold departmental policies, processes, and SOPs to guarantee work consistency and control.
•  Analyze insurance requests against policies, interpreting medical terms, symptoms, diagnostic details, and treatment plans to evaluate the validity of procedure requests.
•  Work collaboratively with Supervisors, Officers, and Medical Coding Coordinators for the accurate evaluation of medical records, ensuring they reflect true medical narratives and comply with legal and coding standards.
•  Strict adherence to HAAD/DHA regulations and medical coding norms.
•  Authorize and forward medical authorization requests (within your designated power) after thorough compliance checks, recording and tracking all approved requests.
•  Address and manage calls, follow-ups, emails, and faxes related to medical authorization from pharmacies or other stakeholders.
•  Coordinate with Doctors/Providers for alternative medical authorization procedures when needed and provide justified recommendations for rejections.
•  Regularly review medical claims policies and procedures to identify and bridge operational gaps, offering solutions for continual growth and efficiency.
•  Generate and provide insightful reports to Management regarding unit operations and policy adherence.

What We Need From You:

• A Bachelor’s degree in Medicine and Surgery (MBBS).
•  2 to 3 years of experience in a relevant field.

Join Us:

Be a part of our dynamic, forward-thinking team that values innovation and efficiency. Suppose you’re eager to contribute to a thriving, multicultural environment in a critical and engaging role. In that case, we’d love to hear from you!