Job Description

Roles & Responsibilities

Review and process assigned insurance pre‑approval requests to ensure completeness and accuracy. Update approvals received from insurers with 100 percent accuracy in internal systems. Coordinate with clinical and administrative teams to obtain missing documentation and clarifications. Meet daily productivity, turnaround time, and quality targets for claims verification and submissions. Perform quantitative and qualitative reviews of medical records to ensure compliance with coding guidelines, DHA requirements, and payer policies. Submit pre‑approvals in line with KPIs to improve first‑round approval rates and reduce rework. Monitor coordination with stakeholders to prevent revenue loss and minimise insurance rejections. Analyse denial trends, implement corrective actions, and escalate rejected or delayed approvals when required. Maintain accurate records and reports related to approvals, denials, and follow‑ups. Support and educate billing, approval, and clinical documentation teams to improve workflows and compliance.

Desired Candidate Profile

Emirati national with a valid family book (mandatory). Certified professional coding qualification from a recognised institution. Medical or paramedical qualification. Minimum of 3 years’ experience in a similar role within revenue cycle management, pre‑approvals, or insurance submissions. Strong medical knowledge to support efficient reconciliation and approvals. Excellent analytical, negotiation, and presentation skills. Ability to make sound decisions under pressure and work towards defined targets. Clear and confident communication skills in both Arabic and English. Strong stakeholder management skills and a collaborative working style.