Prior Authorization Pro — Healthcare

SEHA - Abu Dhabi Health Services Co.; Al Ain; On-site; AED 180,000 - 260,000; Full time

Job summary

SEHA - Abu Dhabi Health Services Co. seeks a Specialist-Authorization to initiate pre-authorizations, gather clinical data, and liaise with payers, physicians, and hospital staff.

The role emphasizes accurate documentation, timely communication, and ensuring medical necessity for procedures. Responsibilities include acting as the primary resource for SEHA authorization processes, collecting information, and updating systems to expedite approvals while coordinating with case management and

Qualifications

• 12 years of Revenue Cycle experience in lieu of degree.
• Healthcare Certification (CRCR and/or CHAM)
• Extensive knowledge of healthcare revenue cycle systems.
• Minimum two (0-2) years of medical insurance verification and authorization required.
• Billing and coding experience preferred.

Responsibilities

• Serve as primary contact for all SEHA Business Entity prior authorization requirements.
• Collect clinical information regarding services to be rendered.
• Contacts insurance companies to obtain benefits, eligibility, and authorization information.
• Updates systems with accurate information obtained.
• Communicates to service line partners when rescheduling is necessary due to authorization constraints.
• Works with inpatient accounts for authorization and timely notification to payers of admission.

Skills

Revenue cycle experience

Insurance verification

Prior authorization

Coding knowledge CPT ICD-10

Communication skills

Education

12 years of Revenue Cycle Experience in lieu of degree

Healthcare Certification (CRCR and/or CHAM)

Tools

Microsoft Office Suite

Outlook

Job description

SEHA - Abu Dhabi Health Services Co. seeks a Specialist-Authorization to initiate pre-authorizations, gather clinical data, and liaise with payers, physicians, and hospital staff.

The role emphasizes accurate documentation, timely communication, and ensuring medical necessity for procedures. Responsibilities include acting as the primary resource for SEHA authorization processes, collecting information, and updating systems to expedite approvals while coordinating with case management and