Outpatient Precertification Medical Officer

Allianz Partners; Dubai; On-site; AED 180,000 - 280,000; Full time

Job summary

Allianz Partners in the United Arab Emirates is seeking a Medical Officer for Outpatient Precertification to expertly adjudicate outpatient claims and ensure compliance with policy terms and turnaround times.

You will review medical documentation, assess treatment plans, request missing data, and conduct utilization reviews while coordinating with providers. Strong MS Office and English skills are required, with knowledge of DHA/HAAD/MOH guidelines and Abu Dhabi/Al Ain markets preferred.

Qualifications

• Bachelor’s degree in Dentistry, Nursing or Paramedics.
• 1–3 years of medical practical experience.
• Certified Medical Coder is preferable.
• Legally permitted to work in country of operations.
• Fluency in MS Office (Excel, Word, Outlook) and internet navigation.
• Strong English communication skills; stakeholder management.
• Abu Dhabi and Al-Ain market knowledge.

Responsibilities

• Precertification team operates 24/7; adjudicates outpatient claims considering technical and clinical perspectives, ensuring policy compliance and turnaround times.
• Reviews outpatient documentation to validate medical necessity and appropriateness of care.
• Assesses proposed treatment plans for alignment with evidence-based guidelines and outpatient benefit structures.
• Requests additional medical documentation and coordinates with providers for clarification.
• Performs utilization review for outpatient services and evaluates billed items, non-covered services and overutilization.
• Reviews claims per CPT and ICD guidelines in line with DHA, DOH/HAAD, MOH. Ensures cost-containment and adherence to network tariffs.
• Maintains daily productivity and service level targets with timely adjudication and workflow management.
• Works with AI, data, analytics and cloud tools, upholding data governance and ethical standards.

Skills

MS Office

English fluency

Stakeholder mgmt

Shift flexibility

Education

Bachelor’s in Dentistry / Nursing / Paramedics

Certified Medical Coder

Job description

Allianz Partners in the United Arab Emirates is seeking a Medical Officer for Outpatient Precertification to expertly adjudicate outpatient claims and ensure compliance with policy terms and turnaround times.

You will review medical documentation, assess treatment plans, request missing data, and conduct utilization reviews while coordinating with providers. Strong MS Office and English skills are required, with knowledge of DHA/HAAD/MOH guidelines and Abu Dhabi/Al Ain markets preferred.