Pre-Authorization Specialist Leader
5 days ago
NMC Royal Khalifa City is currently seeking an experienced Pre-Authorization Specialist Leader to lead our pre-authorization team. The successful candidate will be responsible for reviewing and verifying Pre-Approval requests received from different departments to obtain authorizations required by insurance companies.
Key Responsibilities
- Apply medical knowledge and best insurance practice while reviewing and verifying Pre-Approval requests.
- Ensure details of Pre-Authorization Requests are in line with regulators' standards especially claim adjudication Rules and Business Rules.
- Handling rejected pre-authorization and get required justification from treating doctor to resend it to Insurance Company and obtain approval.
- Supervise and manage the authorization team.
Requirements
- Bachelor's degree/graduate from a recognized university.
- Experience in Insurance Claims management/adjudication (minimum 5 years).
- Excellent command of oral and written English.
- Flexible and able to work under pressure.
- Excellent knowledge of Microsoft applications.
- Experience in managing team.
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