Approval Officer

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Join NMC Healthcare in Dubai as an Approval Officer, a full-time onsite role focused on evaluating pre-approval requests for medical necessity, accurately coding service descriptions, and managing insurance and TPA queries, second opinions, and daily reporting, with shift flexibility. Candidates should hold a bachelor degree in medicine or equivalent, at least two years in insurance claims management, and solid knowledge of ICD CPT DRG and HCPCS, plus excellent English and MS Office skills. To apply, tailor your resume to show hands-on experience with pre-authorization, coding accuracy, claims adjudication, and cross-department collaboration; include concrete examples, highlight reporting outputs, and confirm willingness to work in Dubai on a rotating shift schedule.

DUTIES AND RESPONSIBILITIES

1. Evaluate the Pre Approval requests from medical necessity for the requested service according to the medical data provided and accurately code the service description codes stated on the prior authorization requests, according to accepted medical coding rules, medical guidelines and policy’s schedule of benefits.

1. Respond to Insurance/ TPA queries and liaise with concerned department without any delay.

1. Responsible for receiving, evaluating and escalating second opinion cases and case management.

1. Prepares reports of daily activity as requested for management and assists management in monthly reports as requested.

1. Attend Meetings and Presentation.

1. To adjust duties in case of any sudden/ emergency unplanned leaves by colleagues.

1. Managing and handling pending cases (if any) to the next shift colleagues.

1. Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.

DUTIES AND RESPONSIBILITIES

1. Evaluate the Pre Approval requests from medical necessity for the requested service according to the medical data provided and accurately code the service description codes stated on the prior authorization requests, according to accepted medical coding rules, medical guidelines and policy’s schedule of benefits.

1. Respond to Insurance/ TPA queries and liaise with concerned department without any delay.

1. Responsible for receiving, evaluating and escalating second opinion cases and case management.

1. Prepares reports of daily activity as requested for management and assists management in monthly reports as requested.

1. Attend Meetings and Presentation.

1. To adjust duties in case of any sudden/ emergency unplanned leaves by colleagues.

1. Managing and handling pending cases (if any) to the next shift colleagues.

1. Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.

QUALIFICATION, LICENSURE, EDUCATION, EXPERIENCE, SPECIAL SKILLS

4.1      Bachelor degree in medicine or equivalent medical degree for recognized university.

4.2     Experience in Insurance Claims management/adjudication (minimum 2 years).

4.3       Knowledge in Medical Coding ICD, CPT, DRG and HCPCS.

4.4     Excellent command of oral and written English.

4.5       Flexible and able to work under pressure and in shifts. 

4.6       Excellent knowledge of Microsoft applications.