Preauthorization & Medical Audit Specialist

Sukoon Insurance; Dubai; On-site; AED 180,000 - 300,000; Full time

Job summary

Sukoon Insurance in Dubai seeks a Medical Audit specialist to oversee PAR administration, fraud controls, and adherence to regulatory guidelines. You will manage case reviews, ensure timely resolutions, and support 24/7 PAR operations.

Ideal candidates hold a medical degree with health insurance experience, strong English communication, and knowledge of coding standards. Arabic language skills are a plus and a dynamic, compliant work environment is offered.

Qualifications

• Medical degree or clinical qualification with exposure to health insurance operations.
• Proven experience in medical auditing, PAR, claims adjudication, and FWA control.
• Solid understanding of healthcare systems, policies, and regulatory requirements.
• Excellent communication skills in English; Arabic is an advantage.

Responsibilities

• Coordinate with providers for case management and cost control.
• Handle customer queries and ensure adherence to SLAs and turnaround times.
• Assist in running the PAR unit on a 24/7 basis and pre-authorization processes.
• Conduct onsite audits for suspected fraudulent practice and report to FWA/Network.
• Maintain MIS, quality controls, and SOPs; monitor unit KPIs and SLAs.

Skills

Medical auditing

PAR / pre-authorization

Claims adjudication

FWA control

Policy knowledge

Regulatory compliance

English communication

Arabic skills

Education

Medical degree or clinical qualification

Tools

MS Office Suite

Healthcare claims systems

MIS reporting tools

Job description

Sukoon Insurance in Dubai seeks a Medical Audit specialist to oversee PAR administration, fraud controls, and adherence to regulatory guidelines. You will manage case reviews, ensure timely resolutions, and support 24/7 PAR operations.

Ideal candidates hold a medical degree with health insurance experience, strong English communication, and knowledge of coding standards. Arabic language skills are a plus and a dynamic, compliant work environment is offered.