Medical Officer

Munich RE; Muscat; On-site; OMR 18,000 - 30,000; Full time

Job summary

Munich Re Oman MedNet Group is seeking an Officer - Medical Care Unit to manage pre-approvals for outpatient and inpatient cases and coordinate with network providers for requisitions.

The role requires reviewing requests, assessing medical necessity, and ensuring proper documentation and coding while upholding medical ethics and accuracy. Strong English communication and negotiation skills are essential.

Qualifications

• Bachelor's degree in Nursing or Pharmacy is preferred.
• Minimum 2–3 years of experience in the UAE managed care industry.
• Good knowledge of health insurance concepts and the UAE healthcare system.

Responsibilities

• Review and process outpatient and inpatient pre-authorization requests in line with policies.
• Assess medical necessity based on clinical information and policy terms.
• Ensure accurate medical coding, approvals, and system updates.

Skills

Interpersonal skills

Negotiation

Analytical skills

Problem solving

Planning

Organizational skills

Written English

Education

Bachelor's degree in Nursing or Pharmacy

Tools

MS Office

Excel

PowerPoint

Job description

As a member of Munich Re the Oman MedNet Group is a leading Third-Party Administrator across the MEA region We are currently looking for a Officer -Medical Care Unit the job holder is expected to handle pre-approvals pertaining to outpatient Or In-patient cases and correspond with network providers for pre-approval requisitions

Your Job

• Review and process outpatient and inpatient pre-authorization requests in line with medical policies and benefits
• Assess medical necessity based on clinical information medical guidelines and policy terms
• Ensure accurate medical coding approvals documentation and system updates
• Process pharmacy authorization requests within required turnaround times
• Provide clear rationale for decisions while maintaining accuracy quality and medical ethics
• Identify and escape suspected fraud or abuse and unusual medical trends
• Handle provider queries second opinions and case management efficiently
• Manage changing workloads and shift-based duties while meeting quality and productivity targets

Your Profile: Minimum Qualifications & Experience:

• Bachelor s degree in Nursing or Pharmacy, preferred.
• Minimum 2 3 years of experience in the UAE managed care industry.
• Good knowledge of health insurance concepts and the UAE healthcare system.
• Proficient in MS Office, including Excel and PowerPoint.
• Good command of written English.
• Strong interpersonal and negotiation skills.
• Good analytical, problem-solving, planning, and organizational skills.