Junior RCM Officer ( Pre Authorization )

Fakeeh University Hospital; Dubai; On-site; AED 89,000 - 134,000; Full time

Job summary

Fakeeh University Hospital in Dubai seeks an experienced Pre-Authorization Specialist to review and process healthcare requests, verify insurance eligibility, and communicate decisions to providers and patients. The role collaborates with claims and billing to ensure smooth submissions, maintains accurate records, and resolves information gaps.

Candidates must have 2–3 years of GCC hospital/clinic experience and a Bachelor’s degree in a relevant field.

Qualifications

• Proven clinical experience in Pre-Authorization or Insurance Verification in healthcare (2–3 years).
• Bachelor’s degree in healthcare, business administration, or equivalent.
• 2–3 years hospital/clinic experience in GCC.

Responsibilities

• Review and process pre-authorization requests from providers to determine coverage.
• Verify patient details and insurance eligibility for all requests.
• Communicate approval or denial decisions to providers and patients.
• Review documentation for medical necessity and policy compliance.
• Maintain accurate records and audit-ready documentation.
• Resolve issues with incomplete or incorrect information.
• Coordinate with claims and billing to align approvals with claims submission.
• Respond to inquiries about status of pre-authorization requests.

Skills

Pre-Authorization

Insurance Verification

Education

Bachelor’s degree in healthcare or related field

Job description

• Reviews and processes pre-authorization requests from healthcare providers (hospitals, laboratories, pharmacies) to determine if services are covered.
• Verifies patient details and insurance eligibility for all pre-authorization requests.
• Communicates approval or rejection decisions to healthcare providers and patients based on pre-established criteria.
• Reviews medical documentation submitted with pre-authorization requests to confirm the medical necessity and compliance with insurance policies.
• Maintains accurate records of all processed pre-authorization requests and ensures proper documentation for audits.
• Resolves issues with incomplete or incorrect information related to pre-authorization requests.
• Works closely with the claims and billing departments to ensure that pre-authorization approvals are aligned with the submission of insurance claims.
• Responds to inquiries from patients, providers, and internal stakeholders regarding the status of pre-authorization requests.

Additional Requirements

• Candidates MUST have proven clinical experience in Pre-Authorization, Insurance Verifcation or a related field in a healthcare setting for 2 -3 years.
• Bachelor’s degree in a relevant field healthcare, business administration, or equivalent
• 2-3 years hospital/clinic experience in GCC