Pre-Authorization & Insurance Claims Specialist

NMC healthcare LLC; Abu Dhabi; On-site; AED 223,200 - 334,800; Full time

Job summary

NMC healthcare LLC, located in Abu Dhabi, requires an experienced professional for the role involving Insurance Claims management. Key responsibilities include reviewing pre-authorization requests, evaluating medical necessity, and managing claims processing in compliance with insurance regulations.

Applicants should hold a Bachelor's Degree in Medicine (MBBS) and possess at least 2 years of experience in insurance claims management. Strong English communication skills and proficiency in medical coding are essential. Join a dynamic team and contribute to healthcare excellence.

Qualifications

• Bachelor Degree in Medicine (MBBS) graduate from a recognized university.
• Experience in Insurance Claims management/adjudication (minimum 2 years).
• Experience in Medical Coding ICD, CPT, DRG and HCPCS.
• Excellent command of oral and written English.

Responsibilities

• Apply medical knowledge and best insurance practices.
• Handle rejected pre-authorization and get required justification.
• Prepare reports of daily activity for management.
• Evaluate Pre-Approval requests for medical necessity.
• Respond to Insurance TPA queries.
• Perform night shift duty and on public holidays.
• Handle Auditing Process and assist external Auditors.
• Train Front office Receptionist and Nurses.

Skills

Insurance Claims management

Medical Coding

Microsoft applications

Communication in English

Flexibility under pressure

Education

Bachelor Degree in Medicine (MBBS)

Job description

NMC healthcare LLC, located in Abu Dhabi, requires an experienced professional for the role involving Insurance Claims management. Key responsibilities include reviewing pre-authorization requests, evaluating medical necessity, and managing claims processing in compliance with insurance regulations.

Applicants should hold a Bachelor's Degree in Medicine (MBBS) and possess at least 2 years of experience in insurance claims management. Strong English communication skills and proficiency in medical coding are essential. Join a dynamic team and contribute to healthcare excellence.