Approval Officer

AimGulf; Ras Al Khaimah; On-site; AED 56,000 - 89,000; Full time

Job summary

NMC is seeking a qualified professional in Ras Al Khaimah to handle rejected pre-authorizations, obtain physician justification, and resend to insurance for approval. This role ensures adherence to regulator rules and business standards in claim adjudication.

The candidate will verify insurance eligibility, process authorizations, and communicate with payers while maintaining accurate patient data and documentation. Clinical liaison and clerical support are part of the duties.

Qualifications

• Experience in insurance claims management or pre-authorization processes.
• College Diploma – Any discipline or related fields.

Responsibilities

• Verifies customers’ insurance eligibility and authorization in a timely and accurate manner.
• Communicates payer authorization and eligibility information.
• Sends payer informational correspondence.
• Complete service and procedure authorizations and referrals
• Review the patient’s medical history and insurance coverage for approval.
• If necessary, contact referral physicians for more information.
• Notify the concerned staff and treating physicians once approval is obtained.
• Enter new patient information and update data in our system.
• Assist with other clerical responsibilities as needed.
• Notify branch management of concerns with payer coverage or noncoverage.
• Keep track of the daily production report.
• Maintain the pending approval monitoring system for next-day follow-up.
• Supervise schedules and emergency requirements and address facility queries.
• Guide doctors and staff to follow ICD, CDT and CPT codes to avoid rejection.

Skills

ICD coding

CPT coding

DRG coding

HCPCS coding

Education

College Diploma

Job description

Job Description / Role

Handling the rejected pre-authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval.

Ensure that the details of the Pre-Authorization Requests are in line with the regulators’ standards especially the claim adjudication Rules and Business Rules.

Key Responsibilities

• Verifies customers’ insurance eligibility and authorization in a timely and accurate manner
• Communicates payer authorization and eligibility information.
• Sends payer informational correspondence.
• Complete service and procedure authorizations and referrals
• Review the patient’s medical history and insurance coverage for approval.
• If necessary, contact referral physicians for more information.
• Once approval is obtained, the concerned staff and treating physicians should be notified.
• Enter new patient information and update data in our system.
• As needed, assist with other clerical responsibilities.
• Notifies branch management of concerns with payer coverage or other service noncoverage.
• Keep track of the daily production report.
• Keep the pending approval monitoring system updated for the next day’s follow-up.
• The supervisor and team leader will monitor the schedules and emergency requirements and all the quires from the facility.
• Guide the doctors and concerned staff to follow the correct ICD, CDT and CPT codes to avoid the rejection

Experience Required

• Experience in insurance claims management or pre-authorization (approval) processes, typically 2+ years

Education Qualifications

• College Diploma – Any discipline or related fields.

Skills Required

• Proficiency in medical coding standards: ICD, CPT, DRG, HCPCS

Employment / Job Type

Full Time

About the Company

One of the largest private healthcare providers in the United Arab Emirates, operating hospitals, day surgery centres, clinics, fertility centres, and pharmacies. Founded in Abu Dhabi in the 1970s, NMC handles several million patient visits a year across specialties including surgery, obstetrics, paediatrics, orthopaedics, cardiology, oncology, and diagnostics.

Company Industry

Healthcare

Department / Functional Area

Administration

Closing Date

27 December 2026