Pre-Authorization Specialist — Insurance & Medical Coding

NMC Healthcare; Dubai; On-site; AED 134,000 - 201,000; Full time

Job summary

NMC Healthcare in Dubai is seeking a skilled Insurance Claims Analyst (Pre-Authorization) to review OP/IP requests, verify medical necessity, and code services according to ICD/CPT/DRG guidelines, ensuring alignment with regulator standards.

You will handle rejected requests, obtain doctor justification, and communicate with insurance TPAs. Daily activity reports and month-end closing support are required; flexibility to work shifts and maintain accuracy.

Qualifications

• Bachelor's degree in Medicine or equivalent from a recognized university.
• Minimum 2 years of experience in insurance claims management/adjudication.
• Knowledge of ICD, CPT, DRG, HCPCS coding systems.
• Excellent written and spoken English; able to work in shifts.

Responsibilities

• Review pre-authorization requests for medical necessity and accurately code service descriptions.
• Ensure pre-authorization compliance with regulatory standards and plan benefits.
• Handle rejected requests and obtain doctor justification for resubmission.
• Prepare daily activity reports and assist with month-end reporting.
• Respond to Insurance/TPA queries and liaise with concerned departments promptly.
• Manage second-opinion cases and hand over pending items to next shift.

Skills

Medical knowledge

Insurance claims management

English communication

Microsoft Office

Shift flexibility

Education

Bachelor's degree in Medicine

Tools

ICD coding

CPT coding

DRG coding

HCPCS coding

Job description

NMC Healthcare in Dubai is seeking a skilled Insurance Claims Analyst (Pre-Authorization) to review OP/IP requests, verify medical necessity, and code services according to ICD/CPT/DRG guidelines, ensuring alignment with regulator standards.

You will handle rejected requests, obtain doctor justification, and communicate with insurance TPAs. Daily activity reports and month-end closing support are required; flexibility to work shifts and maintain accuracy.