Medical Pre-Authorization Specialist

NMC; Dubai; On-site; AED 167,000 - 234,000; Full time

Job summary

NMC in Dubai, United Arab Emirates, seeks an experienced Insurance Claims Coordinator to review and verify Pre-Approval requests (OP/IP) and secure authorizations with insurers based on plan coverage and regulatory rules.

The role emphasizes assuring compliance with claim adjudication standards, addressing rejected requests with proper doctor justification, and preparing daily activity reports for management and month-end reporting.

Qualifications

• Excellent command of both written and spoken English.
• Knowledge of medical coding systems including ICD, CPT, DRG, and HCPCS.
• 2+ years of experience in insurance claims management/adjudication.

Responsibilities

• Review and verify Pre-Approval requests for medical necessity and code services per guidelines.
• Respond to insurer/TPA queries and liaise with departments without delay.
• Receive, evaluate, and escalate second opinion and case management needs.
• Prepare daily activity reports and assist with monthly reporting.

Skills

English proficiency

Medical knowledge

Education

Bachelor’s degree in Medicine

Tools

Microsoft Office

Job description

NMC in Dubai, United Arab Emirates, seeks an experienced Insurance Claims Coordinator to review and verify Pre-Approval requests (OP/IP) and secure authorizations with insurers based on plan coverage and regulatory rules.

The role emphasizes assuring compliance with claim adjudication standards, addressing rejected requests with proper doctor justification, and preparing daily activity reports for management and month-end reporting.