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Healthcare Authorization Expert

1 week ago

Abu Dhabi, Abu Dhabi, United Arab Emirates NMC Royal Khalifa City Full time
Job Description

We are seeking an experienced Healthcare Authorization Expert to join our team at NMC Royal Khalifa City. As a key member of our operations team, you will play a crucial role in ensuring the smooth functioning of our healthcare authorization process.

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.