Precertification Officer

Allianz Services; Abu Dhabi; On-site; AED 89,000 - 134,000; Full time

Job summary

Allianz Partners in Abu Dhabi seeks a Precertification Officer to obtain prior authorizations for procedural orders with insurers, ensuring efficient turnaround and KPI achievement.

You will assess treatment necessity, approve or decline based on policy, manage high-cost cases, and communicate decisions to the call centre. Candidates should hold a BSc, have 2+ years in medical insurance, and be proficient in MS Office; UAE work experience preferred.

Qualifications

• Bachelor's degree in a relevant field (BSc).
• 2+ years medical practical experience (from a reputable insurer, broker or TPA is a plus).
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.

Responsibilities

• Obtain prior authorizations and assess approval of medical procedures and policy use.
• Check whether the treatment plan is necessary for the patient.
• Input verbal and written claims approvals regularly and meet productivity targets.
• Make approvals in line with policy conditions and assess high-cost or complex cases.
• Provide clear feedback to the call centre on queries and explain declined claims.

Education

Bachelor of Science

Tools

MS Office

Job description

Job Description:

The Precertification Officer is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers with high efficiency and within the agreed turnaround time to maintain the team KPIs.

What you do

• Assesses approval of medical approvals as well as policy use.
• Check particular treatment plan is necessary for the patient.
• Inputs verbal and written claims approvals regularly.
• Decide approvals as per policy conditions.
• Assess high-cost claims and provide decisions on high-cost and complicated cases.
• Provide clear feedback on queries from call Centre team.
• Provides clients an understanding of any declined medical claims.
• Coordinates workflow & meet deadlines.
• Evaluate claims concerning eligibility.
• Meet daily Precertification productivity target according to claims type/tenure
• Adjudicate Outpatient Precertification on first-in-first-out basis.
• Maintain Productivity TAT of 85% in 10 minutes and 98% within 1st hour and immediate emergency/ VIP
• Adherences 100% to Schedule and Punctuality.
• Decision-Making Responsibility
• Evaluate the High cost claims with efficacy and quantity to meet the daily target for the team, giving the approval for the medical condition according to the guidelines and within the policy term and condition, taking into consideration the market practice, with high liability for the invalid rejection and the customer satisfaction
• AI READINESSWork effectively in an environment shaped by artificial intelligence (AI), machine learning, data, analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.

What you bring

• Bachelors of Science.
• 2+ years Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.

What we offer

Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance. Our products are embedded seamlessly into our partners’ businesses or sold directly to customers, and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care.

At Allianz Partners, Artificial Intelligence (AI) is transforming service delivery and innovation. By leveraging Business Intelligence and Data Analytics, we enhance strategic decision-making and customer experiences. Our commitment to Ethical AI ensures responsible deployment, maintaining data integrity and trust. Conversational AI improves communication, while Emerging Technologies and Generative AI drive industry leadership and new opportunities. With robust Information Security Management, we protect sensitive information, ensuring compliance and security. Embrace the future of AI with Allianz Partners, where possibilities become realities.

Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.

Join us.

Lets care for tomorrow.

Note: Having different strengths, experiences, perspectives and approaches is an integral part of Allianz‘ company culture. One means to achieve this is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company expects from its employees a general openness and a high motivation to regularly change positions and collect experiences across Allianz Group.

Requirements: