Emirati Pre-Approval Officer, HealthHub, Dubai Festival City
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Key skills for this role
About the Role
Review and process assigned insurance pre‑approval requests to ensure completeness and accuracy. Update approvals received from insurers with 100 percent accuracy in internal sy.
Key Skills for This Role
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
Requirements
- Experience in insurance pre approval or claims processing
- Knowledge of DHA requirements and payer policies
- Ability to perform quantitative and qualitative reviews of medical records
- Strong attention to detail and accuracy
- Proficiency in internal systems and data entry
Full Job Posting
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.
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