Pre-Approval Officer - Medical Claims

AlFuttaim; Dubai; On-site; AED 67,000 - 100,000; Full time

Job summary

Al-Futtaim Health is seeking a Pre-Approval Officer - Medical Claims in Dubai to review medical records, verify insurance requirements, and submit accurate pre-approval requests for eligible treatments and services. The role reports to the Revenue Cycle Manager and involves coordinating between insurers, third-party administrators, coding teams and clinical staff.

Ideal candidates have at least three years of experience in medical insurance pre-approvals or related revenue-cycle functions, with

Qualifications

• Minimum 3 years in medical insurance pre-approvals or a similar role.
• Experience reviewing medical records and submitting pre-approval requests.
• Strong knowledge of DHA regulatory requirements.
• Ability to coordinate with insurers, clinicians and billing teams.

Responsibilities

• Review claim forms and pre-approval submissions from verification to payer response.
• Verify patient information, clinical justification and supporting documentation.
• Coordinate with physicians and coding teams to secure approvals.
• Monitor payer requirements and analysis of rejection patterns.
• Ensure submissions comply with DHA regulations.
• Maintain KPI submission timelines.
• Communicate effectively with internal teams and insurers.

Skills

Medical insurance pre-approvals

Medical coding

Claims verification

Payer negotiations

Regulatory compliance

Communication

Education

Recognised professional medical-coding certificate

Job description

Pre-Approval Officer - Medical Claims Job Snapshot * Role: Pre-Approval Officer - Medical Claims * Location: Dubai, United Arab Emirates * Industry: Hospital and Health Care * Function: Claims Processing * Experience: Minimum 3 years in medical insurance pre-approvals or a similar role * Job Type:

Al-Futtaim Health is hiring a Pre-Approval Officer - Medical Claims in Dubai, United Arab Emirates, for a revenue-cycle role within the Hospital and Health Care industry. The position will review medical records, verify insurance requirements and submit accurate pre-approval requests for eligible treatments and services. Reporting to the Revenue Cycle Manager, the officer will coordinate between insurance companies, third-party administrators, coding teams and clinical staff. The primary objectives are to secure approvals promptly, improve first-round acceptance and prevent avoidable revenue loss.

Country: United Arab Emirates City: Dubai Industry: Hospital and Health Care Function: Claims Processing Salary: AED 6000-9000 per month Estimated salary range based on similar jobs in Dubai; please confirm the final offer with the employer. Gender: Any Candidate Nationality: Any Job Type: Full-time Job Requisition ID: 180207

Role Context

Accurate pre-approval processing allows patients to receive authorised care while protecting the healthcare provider from unpaid services. This position will confirm that each request contains complete patient information, clinical justification, coding and supporting documentation. The officer will monitor payer requirements and analyse rejection patterns to improve future submissions. Effective collaboration with physicians and revenue-cycle teams will reduce delays and strengthen the financial performance of clinic operations.

Key Responsibilities

The role will manage claim reviews and pre-approval submissions from initial verification through payer response and internal follow-up.

• Review assigned claim forms through the processing dashboard.
• Update approvals received from insurance companies accurately.
• Contact departments when documents or clinical information are missing.
• Meet daily claim-verification productivity targets.
• Verify patient identity, record details, signatures and required dates.
• Confirm that all reports support the treatment provided.
• Follow medical coding guidelines and regulatory requirements.
• Evaluate records for consistency and documentation adequacy.
• Ensure final diagnoses reflect the treatment and care delivered.
• Review records against third-party reimbursement requirements.
• Notify responsible staff and physicians of documentation deficiencies.
• Recheck completed records to confirm that deficiencies are resolved.
• Submit pre-approval requests within established KPI timelines.
• Improve submission quality to increase first-round approvals.
• Monitor insurance rejections and coordinate suitable corrections.
• Analyse approval behaviour across different payers and corporate plans.
• Submit eligible IP, OP and Pharmacy requests to insurers and third-party administrators.
• Obtain additional information requested by insurance companies.
• Coordinate with physicians to secure clinical justification.
• Support complex cases requiring faster payer approval.
• Ensure PAR submissions comply with DHA and insurance regulations.
• Maintain accurate pre-approval KPI records.
• Educate Billing and Approvals teams on process improvements.
• Coordinate with the Clinical Documentation Improvement team.
• Maintain monthly submission data for each insurance company.
• Analyse revenue-cycle data and identify defaulting payers.
• Recommend corrective actions that reduce financial exposure.

Ideal Profile

Candidates must hold a recognised professional medical-coding certificate and possess at least three years of experience in medical insurance pre-approvals, coding, claims verification or a similar healthcare revenue-cycle position. A strong medical background is required for assessing clinical records and supporting reconciliation activities. Applicants should demonstrate effective payer negotiation, clear communication and the ability to coordinate with physicians and clinic teams. The successful candidate must remain accurate under pressure, manage strict turnaround targets and apply sound judgement when reviewing complex medical and insurance information.

Skills Set

• Medical insurance pre-approvals
• Medical coding
• Claims verification
• Quantitative medical-record analysis
• Qualitative documentation review
• IP, OP and Pharmacy approvals
• DHA regulatory compliance
• PAR submission
• Clinical justification review
• Payer and third-party administrator coordination
• Denial and rejection analysis
• Clinical documentation improvement
• Revenue-cycle management
• KPI monitoring
• Financial risk analysis

Why Join Us

This role offers direct responsibility for improving approval outcomes and protecting healthcare revenue within a growing clinical network. The successful officer will work closely with medical, coding, billing and insurance teams on varied patient cases. Al-Futtaim Health provides long-term stability and opportunities to strengthen expertise in medical coding, payer requirements and revenue-cycle operations. The position also offers meaningful scope to improve documentation standards and patient access to authorised care.

About the Company

Al-Futtaim Group is a diversified, privately held regional business operating across automotive, financial services, real estate, retail and healthcare. The Group employs more than 35,000 people in over 20 countries and partners with more than 200 international brands.