Pre-approval officers
13 hours ago
Pre-approval officers (IP) incl extension About the job Pre-approval officers (IP) incl extension Job Family Summary : The Operations Department is responsible to manage all aspects of claims management including Onsite operations and back end processing. The department primarily works on main objective of submitting the claims in time with highest quality to ensure the client receives the payment with minimal or no rejections. Role Summary : Preapproval Department is based at the hospital site which manages precertification for all OPD, IPD and EPD cases for insured members contracted with the hospital as per designated networks. Major role is at seeking preapproval for services with patient satisfaction-oriented duties. The Associate Pre-Approval is responsible for registration and length of stay (LOS) assignment for all acute care hospitals admissions. Reviews and Discusses with nurses and physicians on denied cases or pending cases. Submits all requests, including required forms and limited documentation when requested, via DHPO/ websites. Notifies Hospitals by written notification of approval, rejection and denial of requests. Applies judgement in reconsideration for appeal of rejected cases. Primary Responsibilities : Preapproval and Precertification for claims requiring approval. Making Cost estimates according to procedures Monitoring and follow up on prior authorization for outpatient/inpatient services Scanning of cases to identify lack of documentation by physician/ reports prior to submitting to payer Contacting the payers/TPA for approval related matters. Communicates adequately with external parties. Contacting the physician/nurses for further clarification to make the claim eligible for preapproval. Identify and analyze problems, take action to resolve, apply sound judgment and take responsibility for their resolution Inform and influence others by clear, concise expression of ideas and information in verbal and written as appropriate Timely and meets deadlines. Reporting trends related to preapproval to reporting TL /Supervisor Job Requirements : Medical Background - Nursing /BAMS/BHMS/MBBS/BDS preferred. Medical Coding knowledge preferred. Certification will be added advantage Fresher for Junior Level post, Medical Billing Knowledge with certification will be as well an added advantage. Proficient in the software modules. (Microsoft Word and Excel) Key Performance Indicators (KPI's) Completing the assigned/allocated preapproval claims as per TL/Supervisor >95% quality (error free) to be achieved on given tasks. Strict Adherence to process and protocols of payers and as well organization Maintain TAT for all approval within 24 to 48 hours #J-18808-Ljbffr
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Team Lead Pre
13 hours ago
Dubai, United Arab Emirates Accumed Full timeJob Openings Team Lead Pre -Approval / Pre- Approval Officer OP & IP About the job Team Lead Pre -Approval / Pre- Approval Officer OP & IP Job Family Summary : The Operations Department is responsible to manage all aspects of claims management including Onsite operations and back end processing. The department primarily works on main objective of submitting...
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Pre-approval Officer
6 days ago
Dubai, United Arab Emirates Al-Futtaim Full timeEstablished in the 1930s as a trading business, Al-Futtaim Group today is one of the most diversified and progressive, privately held regional businesses headquartered in Dubai, United Arab Emirates. Structured into five operating divisions; automotive, financial services, real estate, retail and healthcare; employing more than 35,000 employees across more...
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Team Lead Pre
4 days ago
Dubai, United Arab Emirates ACCUMED Full time**Job Family Summary**: The Operations Department is responsible to manage all aspects of claims management including Onsite operations and back end processing. The department primarily works on main objective of submitting the claims in time with highest quality to ensure the client receives the payment with mínimal or no rejections. **Role Summary**:...
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Pre-Approval Officer
13 hours ago
Dubai, United Arab Emirates Accumed Full timeThe Operations Department is responsible to manage all aspects of claims management including Onsite operations and back end processing. The department primarily works on main objective of submitting the claims in time with highest quality to ensure the client receives the payment with minimal or no rejections. Role Summary Preapproval Department is based at...
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Approval Officer
4 days ago
Dubai, United Arab Emirates NMC Healthcare Full timeUnder the supervision of the Audit Team leader; reviews, sends and follows-up preapproval requests received from various departments in the facility. Coordinates with the Billing Team and other teams of RCM Department in regards to any concerns relating to pre approvals. Responds to quires related to insurance coverage/Approvals of patients and assists in...
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Dubai, United Arab Emirates Al-Futtaim Full time**Job Requisition ID**:172484 Established in the 1930s as a trading business, Al-Futtaim Group today is one of the most diversified and progressive, privately held regional businesses headquartered in Dubai, United Arab Emirates. Structured into five operating divisions; automotive, financial services, real estate, retail and healthcare; employing more than...
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Approval Officer
13 hours ago
Dubai, United Arab Emirates NMC Group Full timeUnder the supervision of the Audit Team leader; reviews, sends and follows-up preapproval requests received from various departments in the facility. Coordinates with the Billing Team and other teams of RCM Department in regards to any concerns relating to pre approvals. Responds to quires related to insurance coverage/Approvals of patients and assists in...
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Approval Officer
4 days ago
Dubai, United Arab Emirates NMC Healthcare Full timeHandling the rejected pre authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval. - Prepares reports of daily activity as requested for management and assists management in month end reporting as requested. - Evaluate the Pre Approval requests from medical necessity for the requested...
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Approval Officer
7 days ago
Dubai, United Arab Emirates NMC Healthcare Full timeThe main responsibility of the insurance department is to process pre-approvals from the In-network insurance companies, so that the patient’s can avail cashless treatment for the approved services. **Direct Billing**:Cashless treatment given to patient with or without taking the approval form the In-network insurance companies. The charges will be later...
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Approval Officer
2 weeks ago
Dubai, United Arab Emirates NMC Healthcare Full timeEvaluate 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 - Respond to Insurance/ TPA queries and...
