Associate, Preauthorization (Contract)

Sukoon Insurance; Dubai; On-site; AED 89,000 - 134,000; Full time

Job summary

Sukoon Insurance in the UAE seeks a qualified professional to process ePAR and PBM preapprovals. You will handle calls and emails, review clinical data, and adjudicate requests per policy terms.

This 1-year contract role requires medical background, strong communication in English (Arabic preferred), and experience in preapproval and PBM. Shift-based schedule applicable; entry-level compensation included.

Qualifications

• Bachelor’s degree in paramedical or nursing; medicine degree preferred.
• Insurance qualification/background essential for similar roles.
• 4–5 years experience (1–2 UAE) in preapproval roles.
• Exposure to preapproval and PBM processes.
• Call centre skills are mandatory.
• Knowledge of local market and regulatory guidelines.

Responsibilities

• Review ePAR and PBM cases; process per guidelines and protocols; issue accurate pre-approvals.
• Answer calls and emails from pharmacies, providers and customers with high service standards.
• Review clinical data against codes and authorize preapproval requests.
• Establish rapport with colleagues and support departmental activities.

Skills

Medical knowledge

Decision making

English & Arabic communication

IT skills (MS Office, health claim系统)

Medical coding

Process design & mapping

Lean Six Sigma

Education

Paramedical/Nursing degree

Medicine degree preferred

Insurance qualification/background

Tools

MS Office

Health claim system

MIS

Job description

The jobholder will be responsible for processing ePAR and PBM cases thru calls and emails.

Responsibilities:

• Ensure timely review of ePAR and PBM cases and process as per prescribed guidelines and protocols. Responsible for issuing accurate Pre-approvals to the providers and deliver excellent customer service. Review pre-approval request and adjudicate as per defined policy terms and conditions/clinical/regulatory guidelines.
• Answer calls and emails from pharmacies, providers, and customers using exemplary customer service skills.
• Review clinical data matching it against specified medical terms and/or diagnosis /procedure codes and follow established procedure for authorizing preapproval request.
• Establish effective rapport with other employees and supervisor and maintain cooperative working relationship; actively support departmental activities.

Skills Required:

• Medically educated and trained with good overall business experience focusing on health insurance.
• Decision making skills to be able to authorize eligible cases.
• Very Good communication skills, verbal and written in English (required) and Arabic (preferable).
• IT skills including MS Office suite, health claim system, MIS.
• Medical coding knowledge.
• Business process design, reengineering, optimization and documentation (workflow, process maps).
• Lean, Six Sigma or other performance/quality improvement methodologies.

Qualifications:

• Bachelor’s degree in paramedical or /nursing. Medicine graduate would be preferred
• Insurance qualification/background is essential in similar role
• Minimum working experience 4-5 years (1-2 years in UAE) in preapproval role
• Candidate must have good exposure in preapproval and PBM
• Call Centre skills are mandatory
• Candidate must possess local market know-how and must be well versed with regulatory guidelines.
• This is a 1-year contract position.
• The role operates on a shift-based schedule, and candidates should be flexible to work assigned shifts.
• This position is aligned with entry-level compensation and benefits.
• Arabic language proficiency is an advantage, as the role may involve interaction with Arabic-speaking customers/stakeholders.