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Approval Officer at NMC Medical Centre

Dubai, Dubai, United Arab Emirates -

Full Time

Start Date

Immediate

Expiry Date

10 Aug, 26

Salary

0.0

Posted On

12 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Coding, Insurance Claims Management, Adjudication, ICD, CPT, DRG, HCPCS, Microsoft Office, Communication, Flexibility, Pressure Management

Industry

Hospitals and Health Care

Description

DUTIES AND RESPONSIBILITIES 1. Evaluate the Pre Approval 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. 2. Respond to Insurance/ TPA queries and liaise with concerned department without any delay. 3. Responsible for receiving, evaluating and escalating second opinion cases and case management. 4. Prepares reports of daily activity as requested for management and assists management in monthly reports as requested. 5. Attend Meetings and Presentation. 6. To adjust duties in case of any sudden/ emergency unplanned leaves by colleagues. 7. Managing and handling pending cases (if any) to the next shift colleagues. 8. Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.

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Responsibilities

The Approval Officer evaluates pre-approval requests for medical necessity and ensures compliance with medical coding rules. They also respond to insurance queries, manage pending cases, and prepare reports for management.