Pre-Authorization & Care Coordination Specialist

NATIONAL GENERAL INSURANCE CO (P.J.S.C); Dubai; On-site; AED 100,000 - 167,000; Full time

Job summary

National General Insurance Co (P.J.S.C) in Dubai seeks a dedicated professional to manage pre-approvals and authorizations for insured members. You will liaise with medical providers and patients, ensuring policy terms are met and timely responses are provided.

The role involves reviewing case records, resolving pharmacy rejections, and processing monthly claims for pharmacy and outpatient clinics. Insurance experience is preferred and a Bachelor’s degree in Pharmacy or Nursing is required.

Qualifications

• Experience in handling pre-approvals/pre-authorizations, reconsiderations, or appeals.
• Strong communication with insured members, providers and internal teams.
• Excellent customer service and ability to respond quickly to inquiries.

Responsibilities

• Provide approvals through online system (DHPO), emails and calls to medical providers based on medical necessity and policy wordings.
• Coordinate between Insurer, patient and provider.
• Handle phone calls and written inquiries related to pre-approvals/pre-authorizations, reconsiderations, or appeals.
• Perform comprehensive case record reviews to verify required data and documentation.
• Handing pharmacy rejections and approving when aligned with indications and policy wordings.
• Process pharmacy and outpatient clinic claims at month-end.

Skills

Customer service

Communication

Attention to detail

Education

Bachelor of Pharmacy

Bachelor of Nursing

Tools

DHPO system

Job description

National General Insurance Co (P.J.S.C) in Dubai seeks a dedicated professional to manage pre-approvals and authorizations for insured members. You will liaise with medical providers and patients, ensuring policy terms are met and timely responses are provided.

The role involves reviewing case records, resolving pharmacy rejections, and processing monthly claims for pharmacy and outpatient clinics. Insurance experience is preferred and a Bachelor’s degree in Pharmacy or Nursing is required.