Approval Officer

NMC Healthcare
Dubai
Workplace: OnsiteFull timeFunction: Communications, PR & CommunityEducation: bachelorsSkills: ["Communication","Reporting","Attention to detail","Ability to work under pressure","Coordination"]

Review and verify OP/IP pre-approval requests from internal departments to obtain insurance authorizations aligned with regulatory standards, claim adjudication rules, and business rules. Handle rejected requests by securing treating-doctor justifications for resubmission. Evaluate medical necessity, apply medical coding (ICD, CPT, DRG, HCPCS) for service descriptions, manage second-opinion cases, and prepare daily and monthly activity reports while coordinating with Insurance/TPA and departments.

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FursaFursa
NMC Healthcare
NMC Healthcare
1 week ago

Approval Officer

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 15 hours agoStatus: Live
Reposted: similar role first listed 2 weeks ago

Job Summary

Review and verify OP/IP pre-approval requests from internal departments to obtain insurance authorizations aligned with regulatory standards, claim adjudication rules, and business rules. Handle rejected requests by securing treating-doctor justifications for resubmission. Evaluate medical necessity, apply medical coding (ICD, CPT, DRG, HCPCS) for service descriptions, manage second-opinion cases, and prepare daily and monthly activity reports while coordinating with Insurance/TPA and departments.
Location: Dubai
Workplace: Onsite
Employment Type: Full time
Job Function: Communications, PR & Community
Seniority: Mid level

Key Responsibilities

  • •Review and verify OP/IP pre-approval requests to obtain insurance authorizations based on plan coverage and regulatory standards.
  • •Assess medical necessity and accurately code service description codes using accepted medical coding rules, medical guidelines, and schedule of benefits.
  • •Handle rejected pre-authorization requests by obtaining treating-doctor justification for resubmission and approval.
  • •Respond to Insurance/TPA queries and liaise with concerned departments without delay.
  • •Manage second-opinion cases and prepare daily activity reports, supporting month-end reporting and shift handover of pending cases.

Key Requirements

  • •Bachelor’s degree in Medicine or an equivalent medical degree from a recognized university.
  • •Minimum 2 years of experience in insurance claims management/adjudication.
  • •Knowledge of medical coding systems including ICD, CPT, DRG, and HCPCS.
  • •Excellent command of written and spoken English.
  • •Proficiency in Microsoft Office applications, with flexibility to work under pressure and in shifts.
Experience:HealthcareInsurance claimsMedical codingHospital insurance
Education:Bachelor's in Medicine
Skills:CommunicationReportingAttention to detailAbility to work under pressureCoordination
Languages:English
Tech Stack:Microsoft OfficeICDCPTDRGHCPCS

Company Brief

NMC Healthcare
Operates a large network of hospitals, medical centers, and specialty clinics across the UAE and the wider Middle East. Provides general and specialized healthcare services, diagnostics, and outpatient care for individuals and families.
Industry: Hospitals & Clinics
Company Size: Enterprise (1,001+ employees)
Growth: Established Company
Headquarters: Abu Dhabi, United Arab Emirates
Founded: 1975
WebsiteLinkedIn