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Approval Officer at ROYAL MEICAL CENTRE

Abu Dhabi, Abu Dhabi Emirate, United Arab Emirates -

Full Time

Start Date

Immediate

Expiry Date

15 Jun, 26

Salary

0.0

Posted On

17 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Knowledge, Insurance Practice, Pre Authorization, Claim Adjudication, Medical Coding, ICD, CPT, DRG, HCPCS, Report Preparation, English Proficiency, Microsoft Applications

Industry

Hospitals and Health Care

Description

2.1 Apply medical knowledge and best insurance practice while reviewing and verifying the Pre Approval requests (OP/ IP) received from different departments to obtain authorizations as required by insurance companies dependent upon the plan coverage for all Insurance patients. Ensure that the details of the Pre Authorization Requests are in line with the regulators’ standards especially the claim adjudication Rules and Business Rules. 2.2 Handling the rejected pre authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval. 2.3 Prepares reports of daily activity as requested for management and assists management in month end reporting as requested.

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Responsibilities

The Approval Officer reviews and verifies Pre Approval requests for insurance patients using medical knowledge and best insurance practices to obtain necessary authorizations. This includes handling rejected requests by obtaining justifications from treating doctors and preparing daily activity reports for management.