Authorization Specialist

Sundus; United Arab Emirates; On-site; AED 120,000 - 180,000; Full time

Job summary

Sundus in Abu Dhabi, UAE is seeking an Authorization Specialist to secure pre-certification and authorization approvals from third-party payers before delivering medical services. You will work closely with clinicians to ensure accurate documentation and timely processing.

Responsibilities include reviewing records, coding, payer communication, and adherence to DOH rules to maintain compliance and meet KPIs.

Qualifications

• Bachelor's degree required.
• Experience in authorization processes preferred.
• Strong knowledge of ICD-10, CPT, and medical coding.
• Excellent communication with patients and payers.
• Ability to use EMR and insurance portals.

Responsibilities

• Obtain pre-certifications and authorizations from third-party payers.
• Review medical records and ensure accurate coding.
• Coordinate with clinicians and departments to gather required information.
• Communicate with payers to provide updates and resolve issues.
• Monitor queues and ensure timely processing per DOH rules.
• Assist with denial management and compliance.
• Support achievement of KPIs and team goals.

Skills

Insurance eligibility

Preauthorization management

Medical coding

Communication

Healthcare operations

Lean workflow

Denial management

Education

Bachelor's degree

Job description

Job Summary
The position of Authorization Specialist is responsible for ensuring that pre-certification and/or authorization approvals are obtained from third party payers prior to delivering medical services to our patients. It requires a heavy involvement with clinicians to ensure that medical information is completed accurately and clearly documented in a timely manner.

Job Title: Authorization Specialist
Job Code: JPC 6742
Location: Abu Dhabi, UAE
Experience: 5 7 years
Education: Bachelors
Job Summary
The position of Authorization Specialist is responsible for ensuring that pre-certification and/or authorization approvals are obtained from third party payers prior to delivering medical services to our patients. It requires a heavy involvement with clinicians to ensure that medical information is completed accurately and clearly documented in a timely manner.
Role Responsibilities

• Insurance Benefits & Eligibility: Interpret insurance plans, Summary of Benefits (SOB), exclusions, insurance cards, network eligibility, patient financial responsibility, and preauthorization requirements.
• Referral & Preauthorization Management: Process referrals and authorization requests accurately and promptly, utilizing insurance portals and following payer-specific requirements.
• Medical Records & Coding: Review medical records, patient history, diagnoses, and treatment plans; ensure appropriate ICD-10, CPT, HCPCS, CDT codes, and medical necessity documentation.
• Communication & Coordination: Communicate effectively with patients, insurance payers, physicians, clinical teams, and external healthcare facilities to obtain required information and provide authorization updates.
• Workflow & Timely Processing: Monitor EMR referral queues, follow established Lean workflows, resolve pending requests within acceptable timeframes, and minimize delays in patient care.
• Denial Management & Compliance: Coordinate with Financial Counselors on denied requests, manage retro-authorizations where appropriate, escalade payer-related trends, and comply with DOH adjudication rules and departmental quality standards.
• Performance & Teamwork: Meet clients core competencies, departmental KPIs, and productivity goals; educate clinicians on authorization requirements, demonstrate teamwork, and perform other assigned duties.