Approval Team Lead

NMC; Abu Dhabi; On-site; AED 60,000 - 120,000; Full time

Job summary

A leading healthcare provider in Abu Dhabi is seeking an individual to manage pre-authorization requests for insurance patients. The role involves applying medical knowledge and insurance practices, supervising the authorization team, and handling rejected requests. Ideal candidates will be responsible and detail-oriented, ensuring compliance with insurance standards. This position offers opportunities for professional growth within a reputable organization.

Responsibilities

• Apply medical knowledge for pre-approval requests.
• Handle rejected pre-authorizations and obtain justifications.
• Supervise the authorization team.
• Manage additional responsibilities from the HOD.

Job description

• Apply medical knowledge and best insurance practice while reviewing and verifying the Pre-Approval requests (OP) received from different departments to obtain authorizations as required by insurance companies dependent upon the plan coverage for all Insurance patients. Ensure that the details of the Pre-Authorization Requests are in line with the regulators’ standards especially the claim adjudication Rules and Business Rules.
• Handling the rejected pre-authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval.
• Handing other responsibilities assigned by HOD.
• Supervise and manage the authorization team.