Approval Officer

NMC Group; Abu Dhabi; On-site; AED 120,000 - 200,000; Full time

Job summary

A healthcare organization in Abu Dhabi is seeking a professional for insurance claims management. The ideal candidate will have a Bachelor's degree in Medicine and at least 2 years of experience in claims adjudication and medical coding. Responsibilities include evaluating pre-approval requests, training staff on insurance processes, and preparing reports. Fluency in English and strong Microsoft skills are required. This role offers a full-time schedule with expectations of flexible working hours.

Qualifications

• Minimum 2 years of experience in insurance claims management/adjudication.
• Experience in medical coding (ICD, CPT, DRG, and HCPCS).
• Excellent command of oral and written English.

Responsibilities

• Evaluate pre‑approval requests for medical necessity.
• Respond to Insurance/TPA queries promptly.
• Train front office staff on insurance details.

Skills

Insurance claims management

Medical coding

Communication skills

Microsoft applications

Education

Bachelor’s degree in Medicine (MBBS)

Job description

Responsibilities

Evaluate pre‑approval requests for medical necessity based on the provided medical data, and accurately code service descriptions according to accepted medical coding rules, medical guidelines, and the policy schedule of benefits.

Respond to Insurance/TPA queries promptly and coordinate with the concerned departments without delay.

Receive, evaluate, and escalate second‑opinion cases and case management as required.

Perform night‑shift duties and work on public holidays as per the duty roster.

Prepare daily activity reports as requested by management and assist with monthly reports.

Handle the auditing process, arrange required documents, and coordinate with coders to support external auditors.

Attend meetings and presentations as required.

Train front office staff, receptionists, and nurses, and keep them updated on insurance details.

Prepare cost estimates for procedures for cash patients.

Adjust duties as needed during sudden or emergency unplanned colleague absences.

Manage and hand over pending cases (if any) to colleagues for the next shift.

Perform any other tasks assigned by the HOD that fall within the scope of the job title.

Comply with all OSH and infection control policies, standards, and procedures, and cooperate with hospital management to meet these requirements.

Work in accordance with documented OSH procedures and instructions specific to assigned responsibilities.

Be familiar with emergency and evacuation procedures.

Report OSH hazards, incidents, near‑misses, and assist in preparing risk assessments and incident reports.

Comply with waste‑management procedures and policies.

Attend applicable OSH/infection control training programs, mock drills, and awareness activities.

Use appropriate personal protective equipment (PPE) and safety systems.

Qualifications

Bachelor’s degree in Medicine (MBBS) from a recognized university.

Minimum 2 years of experience in insurance claims management/adjudication.

Experience in medical coding (ICD, CPT, DRG, and HCPCS).

Excellent command of oral and written English.

Flexible and able to work under pressure.

Strong knowledge of Microsoft applications.

Job Info

• Job Identification 9675
• Job Category Administration
• Posting Date 11/28/2025, 07:25 AM
• Apply Before 12/29/2025, 08:00 PM
• Job Schedule Full time
• Locations Bareen International Hospital, MBZC, Abu Dhabi, AE