Medical Officer - IP

Allianz Services; Abu Dhabi; In loco; AED 120.000 - 160.000; Tempo pieno

Descrizione del lavoro

Allianz Services is seeking a Medical Officer – Inpatient Precertification in Abu Dhabi. You will manage IP precertification cases, review multidisciplinary notes, and ensure compliance with policy terms. The role requires 1–2 years of medical experience and UAE work eligibility in a dynamic, AI-enabled environment.

The position emphasizes turnaround time, high-quality decision making, and collaboration with doctors, coders, and the precertification team to optimize patient care and costs.

Competenze

• MBBS, Nursing, or Pharmacy degree.
• 1–2 years medical experience desirable.
• Knowledge of insurance practices is a plus.
• Eligible to work legally in the UAE.
• Physically fit to perform duties.
• Proficient in MS Office and internet navigation.

Mansioni

• Adjudicates IP precertification cases within turnaround times.
• Performs complete file reviews of multidisciplinary notes and lab reports.
• Requests missing documents essential for decision making.
• Reviews DRG/SOI codes and discusses with doctors and coders when needed.
• Performs utilization review for DRG and FFS cases including final bill review.
• Reviews claims per CPT and ICD guidelines per regulators.
• Adheres to cost containment protocols for medical management.
• Refers cases for second opinions for optimal management and network optimization.
• AI readiness: work with AI, data analytics and cloud tools ethically.

Conoscenze

MS Office proficiency

Medical experience

Insurance industry knowledge

Legally allowed to work in UAE

Physically fit

Formazione

MBBS or Bachelor of Nursing or Pharmacy

Descrizione del lavoro

Job Description:

Medical Officer – Inpatient Precertification is responsible for managing the Inpatient Precertification cases while ensuring that departmental goals, timeline of activities, and compliance measures are met.

What you do

• Precertification team is functional on 24/7 basis. Therefore the Medical Officer will be working on flexible shift basis as per the schedule provided by the Team Leader
• Adjudicates Cases at IP precertification level, authorizes decision within the stipulated turnaround time & with the highest quality standards in view with the policy terms and conditions.
• Performing complete file review with regards to the multidisciplinary notes, TPR charts, physician order’s notes, lab reports, radiology reports, drug chart sheets, consultation notes, nursing notes, progress notes, etc.
• Requesting any medical documentation or finding any missing document which is essential in decision making.
• Performing review of DRG Severity of Illness (SOI) in line with revision of CPT codes / ICD codes, which are being up-coded by the provider – if required discussion with the treating doctor and the medical coders.
• Performing utilization review for DRG cases and FFS cases with regards to and not limited to final bill review + consumables mark ups + non covered item/services + overutilization of services.
• Performing review of claims as per CPT and ICD coding guidelines in line with insurance regulators (DHA,DOH/HAAD,MOH).
• Adhering to the cost containment protocols for medical management cases.
• Referring cases for second opinion when deemed necessary to confirm the best mode of management – also for cost containment to lesser Negotiating factor (NF) facilities within the member’s network or option for home country treatment.
• AI READINESS Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data, analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.

What you bring

• Bachelor’s of Medicine (MBBS), Bachelor of Nursing or Pharmacy.
• 1-2 years medical experience (reputable insurance provider, broker or a TPA experience a plus).
• Knowledge of overall insurance industry practices is a plus.
• Legally permitted to work in the country of operations.
• Physically fit to carry out duties.
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.

What we offer

Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance. Our products are embedded seamlessly into our partners’ businesses or sold directly to customers, and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care.

At Allianz Partners, Artificial Intelligence (AI) is transforming service delivery and innovation. By leveraging Business Intelligence and Data Analytics, we enhance strategic decision-making and customer experiences. Our commitment to Ethical AI ensures responsible deployment, maintaining data integrity and trust. Conversational AI improves communication, while Emerging Technologies and Generative AI drive industry leadership and new opportunities. With robust Information Security Management, we protect sensitive information, ensuring compliance and security. Embrace the future of AI with Allianz Partners, where possibilities become realities.

Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.

Great to have you on board. Lets care for tomorrow.

Note: Having different strengths, experiences, perspectives and approaches is an integral part of Allianz‘ company culture. One means to achieve this is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company expects from its employees a general openness and a high motivation to regularly change positions and collect experiences across Allianz Group.